1
|
Katsuno T, Kimura M, Terada-Hirashima J, Kazuyama Y, Ikeda M, Moriya A, Kurokawa M, Motohashi A, Isaka E, Morishita M, Kawajiri K, Hakkaku K, Saito S, Terayama Y, Sugiura Y, Yamaguchi Y, Takumida H, Watanabe H, Morita C, Tsukada A, Kusaba Y, Tsujimoto Y, Ishida A, Sakamoto K, Hashimoto M, Suzuki M, Takasaki J, Izumi S, Hojo M, Sugiyama H, Sugiura W. Diagnostic accuracy of direct reverse transcription-polymerase chain reaction using guanidine-based and guanidine-free inactivators for SARS-CoV-2 detection in saliva samples. J Virol Methods 2024; 326:114909. [PMID: 38452822 DOI: 10.1016/j.jviromet.2024.114909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 12/30/2023] [Accepted: 03/02/2024] [Indexed: 03/09/2024]
Abstract
This study aimed to evaluate diagnostic accuracy of SARS-CoV-2 RNA detection in saliva samples treated with a guanidine-based or guanidine-free inactivator, using nasopharyngeal swab samples (NPS) as referents. Based on the NPS reverse transcription-polymerase chain reaction (RT-PCR) results, participants were classified as with or without COVID-19. Fifty sets of samples comprising NPS, self-collected raw saliva, and saliva with a guanidine-based, and guanidine-free inactivator were collected from each group. In patients with COVID-19, the sensitivity of direct RT-PCR using raw saliva and saliva treated with a guanidine-based and guanidine-free inactivator was 100.0%, 65.9%, and 82.9%, respectively, with corresponding concordance rates of 94.3% (κ=88.5), 82.8% (κ=64.8), and 92.0% (κ=83.7). Among patients with a PCR Ct value of <30 in the NPS sample, the positive predictive value for the three samples was 100.0%, 80.0%, and 96.0%, respectively. The sensitivity of SARS-CoV-2 RNA detection was lower in inactivated saliva than in raw saliva and lower in samples treated with a guanidine-based than with a guanidine-free inactivator. However, in individuals contributing to infection spread, inactivated saliva showed adequate accuracy regardless of the inactivator used. Inactivators can be added to saliva samples collected for RT-PCR to reduce viral transmission risk while maintaining adequate diagnostic accuracy.
Collapse
Affiliation(s)
- Takashi Katsuno
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan.
| | - Moto Kimura
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Junko Terada-Hirashima
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | | | - Masato Ikeda
- SB Coronavirus Inspection Center Corp., Tokyo, Japan
| | - Ataru Moriya
- Clinical Laboratory Department, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masami Kurokawa
- Clinical Laboratory Department, National Center for Global Health and Medicine, Tokyo, Japan
| | - Ayano Motohashi
- Clinical Laboratory Department, National Center for Global Health and Medicine, Tokyo, Japan
| | - Erina Isaka
- Clinical Laboratory Department, National Center for Global Health and Medicine, Tokyo, Japan
| | - Momoko Morishita
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kazuki Kawajiri
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kazuo Hakkaku
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Susumu Saito
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yuriko Terayama
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yuriko Sugiura
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yoh Yamaguchi
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiroshi Takumida
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiromu Watanabe
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Chie Morita
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Akinari Tsukada
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yusaku Kusaba
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yoshie Tsujimoto
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Akane Ishida
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Keita Sakamoto
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masao Hashimoto
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Manabu Suzuki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Jin Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinyu Izumi
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masayuki Hojo
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Haruhito Sugiyama
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Wataru Sugiura
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| |
Collapse
|
2
|
Tsukada A, Terada-Hirashima J, Takasaki J, Nokihara H, Izumi S, Hojo M, Sugiyama H. Clinical trends among patients with asthma hospitalized for COVID-19 based on data from a nationwide database: an observational study. BMC Pulm Med 2024; 24:105. [PMID: 38431557 PMCID: PMC10909272 DOI: 10.1186/s12890-024-02917-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 02/20/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND While the prevalence of severe cases and mortality rate of coronavirus disease 2019 (COVID-19) appear to be reducing, the clinical characteristics and severity of hospitalized patients with asthma and COVID-19 remain largely unknown. This study aimed to examine the association of asthma with COVID-19 severity and mortality risk. METHODS Data from the Japanese COVID-19 Registry Database were used to investigate the association between COVID-19 and asthma. This study focused on patients hospitalized for COVID-19 in 690 facilities from January 31, 2020, to December 31, 2022. Multivariate analysis using logistic regression was conducted to assess whether asthma, compared with other conditions, represents a risk factor for mortality and invasive mechanical ventilation after COVID-19. RESULTS In total, 72,582 patients with COVID-19 were included in the analysis, of whom, 3731 were diagnosed with asthma. From January 2020 to June 2021, asthma showed no significant association with an increase in mortality (OR 0.837, 95% CI 0.639-1.080, p = 0.184) or invasive mechanical ventilation events (OR 1.084, 95% CI 0.878-1.326, p = 0.440). An analysis conducted after July 2021 yielded similar results. For patients with asthma, factors such as age, body-mass index, sex, and chronic kidney disease increased the risk of mechanical ventilation. However, non-vaccination status and high blood pressure increased the risk of mechanical ventilation during the second half of the study. CONCLUSION Patients with asthma did not have an increased risk of mortality or mechanical ventilation due to COVID-19. However, patients with asthma had a higher risk of more severe COVID-19 due to factors such as advancing age, elevated body-mass index, chronic kidney disease, and non-vaccination.
Collapse
Affiliation(s)
- Akinari Tsukada
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, 162-8655, Japan.
| | - Junko Terada-Hirashima
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, 162-8655, Japan
| | - Jin Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, 162-8655, Japan
| | - Hiroshi Nokihara
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, 162-8655, Japan
| | - Shinyu Izumi
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, 162-8655, Japan
| | - Masayuki Hojo
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, 162-8655, Japan
| | - Haruhito Sugiyama
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, 162-8655, Japan
| |
Collapse
|
3
|
Kawashima A, Yamaguchi Y, Takasaki J. Cytomegalovirus Pneumonia after Pneumocystis Pneumonia on Immunosuppressants. Intern Med 2024; 63:757-758. [PMID: 37438137 PMCID: PMC10982013 DOI: 10.2169/internalmedicine.2026-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/29/2023] [Indexed: 07/14/2023] Open
Affiliation(s)
- Akira Kawashima
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Yoh Yamaguchi
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Jin Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| |
Collapse
|
4
|
Morimoto K, Nonaka M, Yamazaki Y, Nakagawa T, Takasaki J, Tsuyuguchi K, Kitada S, Jumadilova Z, Yuen DW, Ciesielska M, Hasegawa N. Amikacin liposome inhalation suspension for Mycobacterium avium complex pulmonary disease: A subgroup analysis of Japanese patients in the randomized, phase 3, CONVERT study. Respir Investig 2024; 62:284-290. [PMID: 38277865 DOI: 10.1016/j.resinv.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 12/06/2023] [Accepted: 12/22/2023] [Indexed: 01/28/2024]
Abstract
BACKGROUND CONVERT, a randomized, active-controlled, global, Phase 3 trial demonstrated that patients with treatment-refractory Mycobacterium avium complex (MAC) pulmonary disease were more likely to achieve culture conversion with amikacin liposome inhalation suspension (ALIS) plus guideline-based therapy (GBT) versus those continuing on GBT alone. This subgroup analysis reports the efficacy and safety of ALIS in Japanese patients enrolled in CONVERT. METHODS Japanese patients aged ≥20 years with treatment-refractory MAC pulmonary disease from Japanese sites were included. Patients were randomized to receive once-daily 590 mg ALIS + GBT or GBT alone; patients converting by Month 6 remained in the study to complete 12-month treatment followed by a 12-month off-treatment period. Nonconverters exited the study at Month 8. The primary endpoint was the proportion of patients achieving culture conversion by Month 6. RESULTS Of the 59 Japanese patients screened, 48 were randomized to receive ALIS + GBT (n = 34) or GBT alone (n = 14), and 41/48 (85.4 %) were women. The mean (standard deviation) age of patients was 64.5 (8.6) years, and 83.3 % of patients had bronchiectasis at baseline. By Month 6, sputum culture conversion was cumulatively achieved in 9/34 (26.5 %) patients receiving ALIS + GBT versus none receiving GBT alone. Treatment-emergent adverse events were reported in 94.1 % and 100.0 % of patients receiving ALIS + GBT and GBT alone, respectively. No deaths were reported. CONCLUSIONS The efficacy observed in the Japanese subpopulation was largely consistent with that in the overall CONVERT study population, with more patients achieving culture conversion with ALIS + GBT versus GBT alone. Safety profiles were similar between the overall population and the Japanese subpopulation. CLINICAL TRIAL REGISTRATION NCT02344004.
Collapse
Affiliation(s)
- Kozo Morimoto
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24 Matsuyama, Kiyose-shi, Tokyo, 204-8522, Japan.
| | - Mizu Nonaka
- Department of Respiratory Medicine, NHO Ibarakihigashi National Hospital, 825 Terunuma, Tokai-mura, Naka-gun, Ibaraki, 319-1113, Japan
| | - Yoshitaka Yamazaki
- Division of Infectious Diseases, Shinshu Medical Center, 1332 Suzaka, Nagano, 382-8577, Japan
| | - Taku Nakagawa
- Department of Respiratory Medicine, NHO Higashinagoya National Hospital, 5-101 Umemorizaka, Meito-ku, Nagoya-shi, Aichi, 465-8620, Japan
| | - Jin Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Kazunari Tsuyuguchi
- Department of Infectious Diseases, Clinical Research Center, NHO Kinki Chuo Chest Medical Center, 1180 Nagasone-cho, Kita-ku, Sakai, Osaka, 591-8555, Japan
| | - Seigo Kitada
- Kitada Respiratory Clinic, 1-57-1 Kyokoji, Yao-shi, Osaka, 581-0874, Japan
| | - Zhanna Jumadilova
- Clinical Development, Insmed Incorporated, 700 US Highway 202/206 Bridgewater, NJ, 08807, USA
| | - Dayton W Yuen
- Clinical Development, Insmed Incorporated, 700 US Highway 202/206 Bridgewater, NJ, 08807, USA
| | - Monika Ciesielska
- Biometrics, Insmed Incorporated, 700 US Highway 202/206 Bridgewater, NJ, 08807, USA
| | - Naoki Hasegawa
- Center for Clinical Infectious Diseases, Keio University Hospital, 35 Shinanomanchi, Shinju-ku, Tokyo, 160-8582, Japan
| |
Collapse
|
5
|
Sato L, Iwamoto N, Kakumoto Y, Tsuzuki S, Togano T, Ishikane M, Okumura N, Yamada G, Inada M, Suzuki T, Hojo M, Takasaki J, Sasaki R, Kimura A, Teruya K, Okamoto T, Hayakawa K, Hara H, Iseki K, Ohmagari N. Unfractionated Heparin Safety in COVID-19: Incidence and Risks of Bleeding Complications in Japan. J Atheroscler Thromb 2024:64448. [PMID: 38355124 DOI: 10.5551/jat.64448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024] Open
Abstract
AIM Several studies have shown the efficacy and safety of low-molecular-weight heparin use in coronavirus disease 2019 (COVID-19), but that of unfractionated heparin (UFH) has not been investigated. We investigated the prevalence of bleeding complications during UFH administration, its impact on mortality, and the risk factors of bleeding outcomes associated with UFH. METHODS This retrospective cohort study was conducted at a single-center tertiary care hospital, including hospitalized patients with COVID-19. The primary outcomes were measured as the prevalence of bleeding complications during hospitalization, and the secondary outcomes were thromboembolic events and 60-day mortality rates. Logistic regression analysis and propensity score matching were used to assess risk factors for bleeding complications and their impact on mortality. RESULTS Among 1035 included patients, 516 patients were treated with UFH. Twelve (2.3%) patients in the UFH group experienced major bleeding. The prevalence of major bleeding in patients treated with therapeutic-dose UFH was 9.2%. Logistic regression analysis showed that age ≥ 60 years (adjusted odds ratio [aOR], 3.89; 95% confidence interval [CI], 1.01-15.0; P<.05) and COVID-19 severity (aOR, 35.9; 95% CI, 4.57-282; P <.05) were associated with major bleeding complications. After propensity score matching, 11 major and 11 non-major bleeding cases (including minor bleeding) were matched. The 60-day cumulative mortality rate between the two groups did not differ significantly (P=.13, log-rank test). CONCLUSIONS The incidence of major bleeding in COVID-19 patients using therapeutic-dose UFH was relatively high. Critical COVID-19 and older age were risk factors for bleeding complications.
Collapse
Affiliation(s)
- Lubna Sato
- Disease Control and Prevention Center, National Center for Global Health and Medicine
- Department of Emergency and Critical Care Medicine, Fukushima Medical University
| | - Noriko Iwamoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine
- AMR Clinical Reference Center, National Center for Global Health and Medicine
| | - Yuko Kakumoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine
| | - Shinya Tsuzuki
- Disease Control and Prevention Center, National Center for Global Health and Medicine
- AMR Clinical Reference Center, National Center for Global Health and Medicine
| | - Tomiteru Togano
- Department of Hematology, National Center for Global Health and Medicine
| | - Masahiro Ishikane
- Disease Control and Prevention Center, National Center for Global Health and Medicine
- AMR Clinical Reference Center, National Center for Global Health and Medicine
| | - Nobumasa Okumura
- Disease Control and Prevention Center, National Center for Global Health and Medicine
| | - Gen Yamada
- Disease Control and Prevention Center, National Center for Global Health and Medicine
| | - Makoto Inada
- Disease Control and Prevention Center, National Center for Global Health and Medicine
| | - Tetsuya Suzuki
- Disease Control and Prevention Center, National Center for Global Health and Medicine
| | - Masayuki Hojo
- Department of Respiratory Medicine, National Center for Global Health and Medicine
| | - Jin Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine
| | - Ryo Sasaki
- Department of Emergency Medicine and Critical Care, National Center for Global Health and Medicine
| | - Akio Kimura
- Department of Emergency Medicine and Critical Care, National Center for Global Health and Medicine
| | - Katsuji Teruya
- AIDS Clinical Center, National Center for Global Health and Medicine
| | - Tatsuya Okamoto
- Department of Intensive Care Medicine, National Center for Global Health and Medicine
| | - Kayoko Hayakawa
- Disease Control and Prevention Center, National Center for Global Health and Medicine
- AMR Clinical Reference Center, National Center for Global Health and Medicine
| | - Hisao Hara
- Department of Cardiology, National Center for Global Health and Medicine
| | - Ken Iseki
- Department of Emergency and Critical Care Medicine, Fukushima Medical University
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine
- AMR Clinical Reference Center, National Center for Global Health and Medicine
| |
Collapse
|
6
|
Shimasaki S, Baba T, Ogura T, Akasaka K, Matsushima H, Izumi S, Takasaki J, Tsushima K, Kinouchi T, Kichikawa Y, Awashima M, Izumo T, Awano N, Nishimura N, Tazawa R, Mikami A, Kitamura N, Ishii H, Kurihara Y, Taniguchi M, Aikawa S, Okada M, Morita Y, Ishikawa Y, Ohinata A, Nakata K. Short-term inhalation of sargramostim with concomitant high-dose steroids does not hasten recovery in moderate COVID-19 pneumonia: a double-blind, randomised, placebo-controlled trial. Infect Dis (Lond) 2023; 55:857-873. [PMID: 37729076 DOI: 10.1080/23744235.2023.2254380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 08/25/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Granulocyte-macrophage colony stimulating factor (GM-CSF) inhalation may alleviate pulmonary inflammation caused by viral pneumonia. To investigate this, we evaluated its efficacy on COVID-19 pneumonia. METHODS This double-blind, randomised, placebo-controlled study (ClinicalTrials.gov: NCT04642950) evaluated patients in the first half of 2021 at seven Japanese hospitals. Hospitalised patients with COVID-19 pneumonia with moderate hypoxaemia inhaled sargramostim or placebo for 5 days. The primary endpoint was days to achieve a ≥ 2-category improvement from baseline on a modified 7-category ordinal scale. Secondary endpoints included degree of oxygenation, defined by amount of oxygen supply, and serum CCL17 level. RESULTS Seventy-five patients were randomly assigned in a 2:1 ratio to receive sargramostim or placebo, of which 47 and 23 were analysed, respectively. No difference was observed between groups regarding the primary endpoint (8.0 and 7.0 days for sargramostim and placebo, respectively) or in the secondary endpoints, except for CCL17. A post hoc sub-analysis indicated that endpoint assessments were influenced by concomitant corticosteroid therapy. When the cumulative corticosteroid dose was ≤500 mg during Days 1-5, recovery and oxygenation were faster in the sargramostim group than for placebo. Bolus dose corticosteroids were associated with temporarily impaired oxygenation and delayed clinical recovery. The increase in serum CCL17, a candidate prognostic factor, reflected improvement with sargramostim inhalation. The number of adverse events was similar between groups. Two serious adverse events were observed in the sargramostim group without causal relation. CONCLUSIONS Inhaled sargramostim was likely to be effective for COVID-19 pneumonia unless the concomitant corticosteroid dose was high.
Collapse
Affiliation(s)
| | - Tomohisa Baba
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan
| | - Takashi Ogura
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan
| | - Keiichi Akasaka
- Department of Respiratory Medicine, Saitama Red Cross Hospital, Saitama, Japan
| | - Hidekazu Matsushima
- Department of Respiratory Medicine, Saitama Red Cross Hospital, Saitama, Japan
| | - Shinyu Izumi
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Shinjuku-ku, Japan
| | - Jin Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Shinjuku-ku, Japan
| | - Kenji Tsushima
- Department of Pulmonary Medicine, International University of Health and Welfare (IUHW), Chiba, Japan
| | - Toru Kinouchi
- Department of Pulmonary Medicine, International University of Health and Welfare (IUHW), Chiba, Japan
| | - Yoshiko Kichikawa
- Department of Respiratory Medicine, Federation of National Public Service Personnel Mutual Aid Associations, Mishuku Hospital, Meguro-ku, Japan
| | - Maiko Awashima
- Department of Respiratory Medicine, Federation of National Public Service Personnel Mutual Aid Associations, Mishuku Hospital, Meguro-ku, Japan
| | - Takehiro Izumo
- Department of Respiratory Medicine, Japanese Red Cross Medical Center, Shibuya-ku, Japan
| | - Nobuyasu Awano
- Department of Respiratory Medicine, Japanese Red Cross Medical Center, Shibuya-ku, Japan
| | - Naoki Nishimura
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Chuo-ku, Japan
| | - Ryushi Tazawa
- Health Administration Center, Student Support and Health Administration Organization, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Ayako Mikami
- National Center for Global Health and Medicine, Center for Clinical Sciences, Shinjuku-ku, Japan
| | - Nobutaka Kitamura
- Clinical and Translational Research Center, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Haruyuki Ishii
- Department of Respiratory Medicine, Kyorin University School of Medicine, Mitaka, Japan
| | - Yasuyuki Kurihara
- Department of Radiology, St. Luke's International Hospital, Chuo-ku, Japan
| | | | | | | | | | | | | | - Koh Nakata
- Center for Medical Innovation, Division of Pioneering Advanced Therapeutics, Niigata University Medical Dental Hospital, Niigata, Japan
| |
Collapse
|
7
|
Suzuki M, Matsunaga A, Miyoshi-Akiyama T, Terada-Hirashima J, Sadamasu K, Nagashima M, Takasaki J, Izumi S, Hojo M, Ishizaka Y, Sugiyama H. Inhaled ciclesonide does not affect production of antibodies or elimination of virus in patients with COVID-19: Subanalysis of a multicenter, open-label randomized trial. Drug Discov Ther 2023; 17:304-311. [PMID: 37899206 DOI: 10.5582/ddt.2023.01078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
During an earlier multicenter, open-label, randomized controlled trial designed to evaluate the effectiveness of high-dose inhaled ciclesonide in patients with asymptomatic or mild coronavirus disease 2019 (COVID-19), we observed that worsening of shadows on CT without worsening of clinical symptoms was more common with ciclesonide. The present study sought to determine if an association exists between worsening CT shadows and impaired antibody production in patients treated with inhaled ciclesonide. Eighty-nine of the 90 patients in the original study were prospectively enrolled. After exclusions, there were 36 patients each in the ciclesonide and control groups. We analyzed antibody titers against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleocapsid protein at various time points. Changes in viral load during treatment were compared. There was no significant difference in age, sex, body mass index, background clinical characteristics, or symptoms between the two groups. Although evaluation on day 8 suggested a greater tendency for worsening shadows on CT in the ciclesonide group (p = 0.072), there was no significant difference between them in the ability to produce antibodies (p = 0.379) or the maximum antibody titer during the clinical course. In both groups, worsening CT shadows and higher viral loads were observed on days 1-8, suggesting ciclesonide does not affect clearance of the virus (p = 0.134). High-dose inhaled ciclesonide did not impair production of antibodies against SARS-CoV-2 or affect elimination of the virus, suggesting that this treatment can be used safely in patients with COVID-19 patients who use inhaled steroids for asthma and other diseases.
Collapse
Affiliation(s)
- Manabu Suzuki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Akihiro Matsunaga
- Department of Intractable Diseases, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tohru Miyoshi-Akiyama
- Pathogenic Microbe Laboratory, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Junko Terada-Hirashima
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kenji Sadamasu
- Tokyo Metropolitan Institute of Public Health, Tokyo, Japan
| | - Mami Nagashima
- Tokyo Metropolitan Institute of Public Health, Tokyo, Japan
| | - Jin Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinyu Izumi
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masayuki Hojo
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yukihito Ishizaka
- Department of Intractable Diseases, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Haruhito Sugiyama
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| |
Collapse
|
8
|
Lee S, Nguyen NHT, Takaoka S, Do AD, Shirayama Y, Nguyen QP, Akutsu Y, Takasaki J, Ohkado A. A Study on the Health-Related Issues and Behavior of Vietnamese Migrants Living in Japan: Developing Risk Communication in the Tuberculosis Response. Int J Environ Res Public Health 2023; 20:6150. [PMID: 37372738 DOI: 10.3390/ijerph20126150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 06/08/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023]
Abstract
Ensuring a healthy lifestyle for the increasing number of Vietnamese migrants living in Japan is a key public health issue, including infectious disease responses such as tuberculosis (TB). To develop risk communication in relation to the TB response, this study aimed to explore the health issues and health-related behaviors of Vietnamese migrants living in Japan using a mixed method. A survey was conducted on Vietnam-born migrants, aged 18 years and over, in Tokyo. The survey consisted of questions on the following components: (1) demographics; (2) health-related issues and behavior; and (3) health-seeking behavior, information, and communication. A total 165 participants participated in the survey. The majority of the participants were young adults. 13% of the participants responded that they were concerned about their health. Moreover, 22% and 7% of the participants reported weight loss and respiratory symptoms, respectively. 44% of the participants answered they had no one to consult about their health in Japan when they needed it, and 58% answered they had no awareness of any Vietnamese-language health consultation services. Logistic regression analysis revealed that people who contact family members living in Vietnam or overseas using social networking services (SNSs) when they needed to consult someone about their health (adjusted odds ratio (AOR) = 6.09, 95% confidence interval (CI) 1.52-24.43) were more likely to present with one or more of the typical TB symptoms, compared to those who did not consult someone in this manner. Current smokers (OR = 3.08, 95% CI 1.15-8.23) were more likely to have health problems compared to non-smokers. The key informant interviews revealed that individual factors, the health system, and socio-environmental factors may hinder Vietnamese migrants' health-seeking and health-information-seeking behaviors in Japan. TB risk communication approaches for migrants need to be developed considering their health-related behaviors while addressing their health needs.
Collapse
Affiliation(s)
- Sangnim Lee
- Department of Epidemiology and Clinical Research, The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Kiyose City 204-8533, Tokyo, Japan
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Bunkyo-ku 113-8421, Tokyo, Japan
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Shinjuku-ku 162-8655, Tokyo, Japan
- TB Action Network, Kiyose-shi 204-8533, Tokyo, Japan
| | - Nhan Huu Thanh Nguyen
- TB Action Network, Kiyose-shi 204-8533, Tokyo, Japan
- Master's Program in Global Leadership, Vietnam Japan University, Hanoi 77000, Vietnam
| | - Shori Takaoka
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Bunkyo-ku 113-8421, Tokyo, Japan
- TB Action Network, Kiyose-shi 204-8533, Tokyo, Japan
| | - An Dang Do
- TB Action Network, Kiyose-shi 204-8533, Tokyo, Japan
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku 113-0033, Tokyo, Japan
| | - Yoshihisa Shirayama
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Bunkyo-ku 113-8421, Tokyo, Japan
| | - Quy Pham Nguyen
- TB Action Network, Kiyose-shi 204-8533, Tokyo, Japan
- Department of Medical Oncology, Kyoto Miniren Central Hospital, Kyoto-shi 616-8147, Kyoto, Japan
| | - Yusuke Akutsu
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Bunkyo-ku 113-8421, Tokyo, Japan
- TB Action Network, Kiyose-shi 204-8533, Tokyo, Japan
| | - Jin Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Shinjuku-ku 162-8655, Tokyo, Japan
| | - Akihiro Ohkado
- Department of Epidemiology and Clinical Research, The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Kiyose City 204-8533, Tokyo, Japan
| |
Collapse
|
9
|
Ishii S, Kimura M, Miyoshi-Akiyama T, Moriya A, Kurokawa M, Isaka E, Terada-Hirashima J, Takasaki J, Izumi S, Hojo M, Sugiyama H. Examination of the utility of the COVID-19 detection kit, TRC Ready ® SARS-CoV-2 i for nasopharyngeal swabs. Drug Discov Ther 2023; 17:134-138. [PMID: 36948642 DOI: 10.5582/ddt.2022.01106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
The reverse transcription polymerase chain reaction (RT-PCR) offers high sensitivity, but has some drawbacks, such as the time required for the RNA extraction. Transcription reverse-transcription concerted reaction (TRC) Ready® SARS-CoV-2 i is easy to use and can be performed in about 40 minutes. TRC Ready® SARS-CoV-2 i and real-time one-step RT-PCR using the TaqMan probe tests of cryopreserved nasopharyngeal swab samples from patients diagnosed with COVID-19 were compared. The primary objective was to examine the positive and negative concordance rates. A total of 69 samples cryopreserved at -80° C were examined. Of the 37 frozen samples that were expected to be RT-PCR positive, 35 were positive by the RT-PCR method. TRC Ready® SARS-CoV-2 i detected 33 positive cases and 2 negative cases. One frozen sample that was expected to be RT-PCR positive was negative on both TRC Ready® SARS-CoV-2 i and RT-PCR. In addition, one frozen sample that was expected to be RT-PCR positive was positive by the RT-PCR method and negative by TRC Ready® SARS-CoV-2 i. Of the 32 frozen samples that were expected to be RT-PCR negative, both the RT-PCR method and TRC Ready® SARS-CoV-2 i yielded negative results for all 32 samples. Compared with RT-PCR, TRC Ready® SARS-CoV-2 i had a positive concordance rate of 94.3% and a negative concordance rate of 97.1%. TRC Ready® SARS-CoV-2 i can be utilized in a wide range of medical sites such as clinics and community hospitals due to its ease of operability, and is expected to be useful in infection control.
Collapse
Affiliation(s)
- Satoru Ishii
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Moto Kimura
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | | | - Ataru Moriya
- Laboratory Testing Department, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masami Kurokawa
- Laboratory Testing Department, National Center for Global Health and Medicine, Tokyo, Japan
| | - Erina Isaka
- Laboratory Testing Department, National Center for Global Health and Medicine, Tokyo, Japan
| | - Junko Terada-Hirashima
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Jin Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinyu Izumi
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masayuki Hojo
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Haruhito Sugiyama
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| |
Collapse
|
10
|
Tachi Y, Sato L, Ishikane M, Yamada G, Motohashi A, Ando H, Hayakawa K, Takasaki J, Katsuragawa Y, Ohmagari N. A case of prosthetic joint infection caused by Mycobacterium tuberculosis complicated secondary bacterial infection after knee joint replacement surgery. J Infect Chemother 2023; 29:367-370. [PMID: 36528274 DOI: 10.1016/j.jiac.2022.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/18/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022]
Abstract
Mycobacterium tuberculosis (M. tuberculosis) is a rare cause of prosthetic joint infection (PJI). Previous studies have reported that many cases of PJI caused by M. tuberculosis have no medical history of active tuberculosis (TB) or other localization, which contributes to diagnostic difficulties. Furthermore, owing to the limited number of studies on treatment, appropriate treatment strategies, such as the duration of anti-tuberculosis (anti-TB) drugs and surgical indications, remain unclear. We report a case of PJI caused by M. tuberculosis and secondary pyogenic arthritis caused by Staphylococcus aureus and Streptococcus dysgalactiae in a 67-year-old man after knee joint replacement surgery in Japan, which was a moderately endemic country until 2020 and a low endemic country since 2021. Although he had no past medical history or close contact with TB, he was diagnosed with PJI caused by M. tuberculosis, following the culture of a synovectomy specimen. He underwent two-stage surgery and was treated with anti-TB drugs for a total of 12 months and recovered without recurrence. Based on our case and previous studies, there are three points of clinical significance for PJI caused by M. tuberculosis. First, about one year of anti-TB drugs with two staged joint revision resulted in a good course of treatment. Second, surgical treatment might be considered in cases complicated by secondary bacterial infection. Third, because the diagnosis of PJI caused by M. tuberculosis is difficult, TB should be considered in the differential diagnosis of routine bacterial culture-negative PJI, especially in endemic areas.
Collapse
Affiliation(s)
- Yurika Tachi
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Lubna Sato
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masahiro Ishikane
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan.
| | - Gen Yamada
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Ayano Motohashi
- Clinical Laboratory, National Center for Global Health and Medicine, Tokyo, Japan
| | - Honami Ando
- Clinical Laboratory, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kayoko Hayakawa
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Jin Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yozo Katsuragawa
- Department of Orthopedic Surgery, Center Hospital of the National Center for Global Health and Medicine, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| |
Collapse
|
11
|
Katsuno T, Suzuki M, Morishita M, Kawajiri K, Saito S, Horikawa Y, Ueki Y, Yamaguchi Y, Takumida H, Watanabe H, Morita C, Tsukada A, Kusaba Y, Tsujimoto Y, Ishida A, Sakamoto K, Hashimoto M, Terada J, Takasaki J, Izumi S, Hojo M, Sugiyama H. High-flow nasal cannula for severe COVID-19 patients in a Japanese single-center, retrospective, observational study: 1 year of clinical experience. Glob Health Med 2023; 5:47-53. [PMID: 36865899 PMCID: PMC9974223 DOI: 10.35772/ghm.2022.01054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 01/04/2023] [Accepted: 01/09/2023] [Indexed: 01/15/2023]
Abstract
High-flow nasal cannula (HFNC) can be effective in treating type 1 respiratory failure by reducing the severity of coronavirus disease 2019 (COVID-19). The purpose of this study was to assess the reduction of disease severity and safety of HFNC treatment in patients with severe COVID-19. We retrospectively observed 513 consecutive patients with COVID-19 admitted to our hospital from January 2020 to January 2021. We included patients with severe COVID-19 who received HFNC for their deteriorating respiratory status. HFNC success was defined as improvement in respiratory status after HFNC and transfer to conventional oxygen therapy, while HFNC failure was defined as transfer to non-invasive positive pressure ventilation or ventilator, or death after HFNC. Predictive factors associated with failure to prevent severe disease were identified. Thirty-eight patients received HFNC. Twenty-five (65.8%) patients were classified in the HFNC success group. In the univariate analysis, age, history of chronic kidney disease (CKD), non-respiratory sequential organ failure assessment (SOFA) ≥ 1, oxygen saturation to fraction of inspired oxygen ratio (SpO2/FiO2) before HFNC ≤ 169.2, were significant predictors of HFNC failure. Multivariate analysis revealed that SpO2/FiO2 value before HFNC ≤ 169.2 was an independent predictor of HFNC failure. No apparent nosocomial infection occurred during the study period. Appropriate use of HFNC for acute respiratory failure caused by COVID-19 can reduce the severity of severe disease without causing nosocomial infection. Age, history of CKD, non-respiratory SOFA before HFNC ≤ 1, and SpO2/FiO2 before HFNC ≤ 169.2 were associated with HFNC failure.
Collapse
Affiliation(s)
| | - Manabu Suzuki
- Address correspondence to:Manabu Suzuki, Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan. E-mail:
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Ishii S, Ishida A, Sugiura Y, Takasaki J, Izumi S, Hojo M. Examination of the utility of cryobiopsy for tuberculous pleurisy in thoracoscopy: A report of seven cases. Respir Med Case Rep 2023; 43:101840. [PMID: 37064571 PMCID: PMC10091113 DOI: 10.1016/j.rmcr.2023.101840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 02/12/2023] [Accepted: 03/17/2023] [Indexed: 04/03/2023] Open
Abstract
Thoracoscopy under local anaesthesia is effective for the diagnosis of tuberculous pleurisy (TP), mesothelioma and pleural metastases of lung cancer, etc. It has recently been reported that cryobiopsy is useful for obtaining sufficient tissue, achieving a greater depth, and avoiding crush artefact than biopsy forceps. However, the utility of the tissue obtained by cryobiopsy for culture for diagnosing TP is unknown. We compared positivity rates of tissue culture obtained by biopsy forceps and cryobiopsy in seven TP patients. The median tissue size was 2 mm by biopsy forceps and 6 mm by cryobiopsy. The pathological diagnostic rate of pleural tissue was 85.7% with biopsy forceps and 100% with cryobiopsy. However, the positivity rate of tissue culture was 57.1% with biopsy forceps and 28.5% with cryobiopsy. Since rapid freezing with a cryoprobe makes it difficult for bacteria to grow, it is possible that cryobiopsy might not be useful for obtaining a tissue culture in TP cases. However, since the sample size of this study was small, analysis of more cases is required to confirm our results.
Collapse
|
13
|
Uchihara M, Kodani N, Bouchi R, Saito S, Miyazato Y, Sugimoto H, Umamoto K, Kobayashi M, Ihana-Sugiyama N, Ohsugi M, Tanabe A, Ueki K, Takasaki J, Hojo M, Kajio H. Glycemic control using intermittently scanned continuous glucose monitoring in patients with diabetes requiring methylprednisolone therapy for severe COVID-19. Glob Health Med 2022; 4:336-340. [PMID: 36589220 PMCID: PMC9773227 DOI: 10.35772/ghm.2022.01053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 11/10/2022] [Accepted: 11/15/2022] [Indexed: 11/21/2022]
Abstract
In patients with severe coronavirus disease 2019 (COVID-19) with diabetes, glycemic control is essential for a better outcome, however, we face difficulty controlling hyperglycemia induced by high-dose glucocorticoids. We report five cases of severe COVID-19 patients with diabetes, whose glycemic control was managed using an intermittently scanned continuous glucose monitoring (isCGM) system during methylprednisolone therapy. Patients using isCGM showed significantly lower average blood glucose levels and significantly higher total daily insulin dose during the methylprednisolone therapy, compared to patients under regular blood glucose monitoring. The use of isCGM enables remote glucose monitoring, and this can reduce the risks of healthcare workers who have frequent contact with the patients. Thus, we suggest that using isCGM should be considered in hospitalized patients with diabetes under the COVID-19 pandemic to achieve better glycemic control and to minimize the possible risks of healthcare workers.
Collapse
Affiliation(s)
- Masaki Uchihara
- Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine, Tokyo, Japan
| | - Noriko Kodani
- Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine, Tokyo, Japan;,Address correspondence to:Noriko Kodani, Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine, Toyama 1-21-1, Shinjuku-ku, Tokyo 162-8655, Japan. E-mail:
| | - Ryotaro Bouchi
- Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine, Tokyo, Japan;,Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Sho Saito
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yusuke Miyazato
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hirofumi Sugimoto
- Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kotaro Umamoto
- Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine, Tokyo, Japan
| | - Michi Kobayashi
- Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine, Tokyo, Japan
| | - Noriko Ihana-Sugiyama
- Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine, Tokyo, Japan;,Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Mitsuru Ohsugi
- Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine, Tokyo, Japan;,Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Akiyo Tanabe
- Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kohjiro Ueki
- Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine, Tokyo, Japan;,Department of Molecular Diabetic Medicine, Diabetes Research Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Jin Takasaki
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan;,Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masayuki Hojo
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiroshi Kajio
- Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine, Tokyo, Japan
| |
Collapse
|
14
|
Lee S, Aung MN, Kawatsu L, Uchimura K, Miyahara R, Takasaki J, Ohkado A, Yuasa M. Characteristics and Treatment Outcomes among Migrants with Pulmonary Tuberculosis: A Retrospective Cohort Study in Japan, 2009-2018. Int J Environ Res Public Health 2022; 19:12598. [PMID: 36231897 PMCID: PMC9566645 DOI: 10.3390/ijerph191912598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/28/2022] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
This study aimed to describe characteristics and treatment outcomes of overseas-born pulmonary tuberculosis (PTB) patients in Japan, and identify the factors associated with "treatment non-success". We conducted a retrospective analysis of overseas-born patients with drug-susceptible PTB using cohort data of PTB cases newly registered in the Japan tuberculosis (TB) surveillance system between 2009 and 2018. Overall, 9151 overseas-born PTB cases were included in this study, and 70.3% were aged 34 years old or younger. "Students of high school and higher" (28.6%) and "regular workers other than service related sectors" (28.5%) accounted for over half of the study population, and they have continued to increase. Overall, the treatment success rate was 67.1%. Transferred-out constituted the largest proportion (14.8%) among the treatment non-success rate (32.9%). Multiple logistic regression analysis revealed patients whose health insurance type was "others and unknown", including the uninsured (adjusted OR (AOR) = 3.43: 95% Confidence Intervals (CI) 2.57-4.58), those diagnosed as TB within "one year" (AOR = 2.61, 95% CI 1.97-3.46) and "1-5 years" (AOR = 2.44, 95% CI 1.88-3.17) of arrival in Japan, and males (AOR = 1.34, 95% CI 1.16-1.54), which were the main factors associated with treatment non-success. These findings imply that Japan needs to develop TB control activities considering the increasing trends of overseas-born PTB patients, the majority of whom are young and highly mobile. There is a need to pay greater attention to overseas-born PTB patients diagnosed within a short duration after entering Japan, who may be socially and economically disadvantaged for their treatment completion.
Collapse
Affiliation(s)
- Sangnim Lee
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Bunkyo-ku, Tokyo 113-8421, Japan
- Department of Epidemiology and Clinical Research, The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Kiyose City, Tokyo 204-8533, Japan
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Myo Nyein Aung
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Bunkyo-ku, Tokyo 113-8421, Japan
- Global Health Service, Faculty of International Liberal Arts, Juntendo University, Bunkyo-ku, Tokyo 113-8421, Japan
- Advanced Research Institute for Health Sciences, Juntendo University, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Lisa Kawatsu
- Department of Epidemiology and Clinical Research, The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Kiyose City, Tokyo 204-8533, Japan
| | - Kazuhiro Uchimura
- Department of Epidemiology and Clinical Research, The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Kiyose City, Tokyo 204-8533, Japan
| | - Reiko Miyahara
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Shinjuku-ku, Tokyo 162-8640, Japan
- Genome Medical Science Project, The Research Institute, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Jin Takasaki
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo 162-8655, Japan
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Akihiro Ohkado
- Department of Epidemiology and Clinical Research, The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Kiyose City, Tokyo 204-8533, Japan
| | - Motoyuki Yuasa
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Bunkyo-ku, Tokyo 113-8421, Japan
- Global Health Service, Faculty of International Liberal Arts, Juntendo University, Bunkyo-ku, Tokyo 113-8421, Japan
| |
Collapse
|
15
|
Yamaguchi Y, Hashimoto M, Saito S, Morita T, Tsukada A, Kusaba Y, Katsuno T, Suzuki M, Takasaki J, Izumi S, Matsunaga A, Ishizaka Y, Hojo M, Sugiyama H. Suspected Tuberculous Pleurisy and Coronavirus Disease 2019 Comorbidity. Intern Med 2022; 61:913-916. [PMID: 34980790 PMCID: PMC8987240 DOI: 10.2169/internalmedicine.6920-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
A 33-year-old woman with a fever, cough, and pharyngitis was admitted after left-sided pleural effusion was detected. The fever and upper respiratory symptoms were confirmed, and she was diagnosed with coronavirus disease (COVID-19) after showing a positive polymerase chain reaction (PCR) test. After thoracentesis, pleural fluid revealed elevated adenosine deaminase values and a positive QuantiFeron test; tuberculous pleurisy was thus suspected. Subsequent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) PCR and anti-SARS-CoV-2 Spike IgG tests were negative, suggesting that the initial PCR result had been erroneous. However, we were unable to confirm this. Data concerning COVID-19 diagnostics are insufficient at present. It is important to make comprehensive judgments regarding the diagnosis and treatment of patients as well as public health.
Collapse
Affiliation(s)
- Yoh Yamaguchi
- Department of Respiratory Medicine, Hospital, National Center for Global Health and Medicine, Japan
| | - Masao Hashimoto
- Department of Respiratory Medicine, Hospital, National Center for Global Health and Medicine, Japan
| | - Susumu Saito
- Department of Respiratory Medicine, Hospital, National Center for Global Health and Medicine, Japan
| | - Tie Morita
- Department of Respiratory Medicine, Hospital, National Center for Global Health and Medicine, Japan
| | - Akinari Tsukada
- Department of Respiratory Medicine, Hospital, National Center for Global Health and Medicine, Japan
| | - Yusaku Kusaba
- Department of Respiratory Medicine, Hospital, National Center for Global Health and Medicine, Japan
| | - Takashi Katsuno
- Department of Respiratory Medicine, Hospital, National Center for Global Health and Medicine, Japan
| | - Manabu Suzuki
- Department of Respiratory Medicine, Hospital, National Center for Global Health and Medicine, Japan
| | - Jin Takasaki
- Department of Respiratory Medicine, Hospital, National Center for Global Health and Medicine, Japan
| | - Shinyu Izumi
- Department of Respiratory Medicine, Hospital, National Center for Global Health and Medicine, Japan
| | - Akihiro Matsunaga
- Department of Intractable Diseases, Research Institute, National Center for Global Health and Medicine, Japan
| | - Yukihito Ishizaka
- Department of Intractable Diseases, Research Institute, National Center for Global Health and Medicine, Japan
| | - Masayuki Hojo
- Department of Respiratory Medicine, Hospital, National Center for Global Health and Medicine, Japan
| | - Haruhito Sugiyama
- Department of Respiratory Medicine, Hospital, National Center for Global Health and Medicine, Japan
| |
Collapse
|
16
|
Suzuki M, Hayakawa K, Asai Y, Matsunaga N, Terada M, Ohtsu H, Toyoda A, Takasaki J, Hojo M, Yanagawa Y, Saito S, Yamamoto K, Ide S, Akiyama Y, Suzuki T, Moriya A, Mezaki K, Ohmagari N. Evaluation of the detection of other pathogens in hospitalized patients with COVID-19 at a tertiary hospital in Japan. Jpn J Infect Dis 2022; 75:419-422. [DOI: 10.7883/yoken.jjid.2021.232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Michiyo Suzuki
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Kayoko Hayakawa
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Yusuke Asai
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Japan
| | - Nobuaki Matsunaga
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Japan
| | - Mari Terada
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Hiroshi Ohtsu
- Center for Clinical Sciences, National Center for Global Health and Medicine, Japan
| | - Ako Toyoda
- Center for Clinical Sciences, National Center for Global Health and Medicine, Japan
| | - Jin Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Masayuki Hojo
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Yasuaki Yanagawa
- AIDS Clinical Center, National Center for Global Health and Medicine, Japan
| | - Sho Saito
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Kei Yamamoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Satoshi Ide
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Yutaro Akiyama
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Tetsuya Suzuki
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Ataru Moriya
- Microbiology Laboratory, National Center for Global Health and Medicine, Japan
| | - Kazuhisa Mezaki
- Microbiology Laboratory, National Center for Global Health and Medicine, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| |
Collapse
|
17
|
Uchihara M, Bouchi R, Kodani N, Saito S, Miyazato Y, Umamoto K, Sugimoto H, Kobayashi M, Hikida S, Akiyama Y, Ihana‐Sugiyama N, Osugi M, Tanabe A, Ueki K, Takasaki J, Hojo M, Kajio H. Impact of newly diagnosed diabetes on COVID‐19 severity and hyperglycemia. J Diabetes Investig 2022; 13:1086-1093. [PMID: 35075818 PMCID: PMC9153833 DOI: 10.1111/jdi.13754] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/11/2022] [Accepted: 01/19/2022] [Indexed: 01/08/2023] Open
Abstract
Aims/Introduction Materials and Methods Results Conclusions
Collapse
Affiliation(s)
- Masaki Uchihara
- Department of Diabetes, Endocrinology and Metabolism National Center for Global Health and Medicine Toyama 1‐21‐1, Shinjuku‐ku Tokyo 162‐8655 Japan
| | - Ryotaro Bouchi
- Department of Diabetes, Endocrinology and Metabolism National Center for Global Health and Medicine Toyama 1‐21‐1, Shinjuku‐ku Tokyo 162‐8655 Japan
- Diabetes and Metabolism Information Center Research Institute National Center for Global Health and Medicine Toyama 1‐21‐1, Shinjuku‐ku Tokyo 162‐8655 Japan
| | - Noriko Kodani
- Department of Diabetes, Endocrinology and Metabolism National Center for Global Health and Medicine Toyama 1‐21‐1, Shinjuku‐ku Tokyo 162‐8655 Japan
| | - Sho Saito
- Disease Control and Prevention Center National Center for Global Health and Medicine Toyama 1‐21‐1, Shinjuku‐ku Tokyo 162‐8655 Japan
| | - Yusuke Miyazato
- Disease Control and Prevention Center National Center for Global Health and Medicine Toyama 1‐21‐1, Shinjuku‐ku Tokyo 162‐8655 Japan
| | - Kotaro Umamoto
- Department of Diabetes, Endocrinology and Metabolism National Center for Global Health and Medicine Toyama 1‐21‐1, Shinjuku‐ku Tokyo 162‐8655 Japan
| | - Hirofumi Sugimoto
- Department of Diabetes, Endocrinology and Metabolism National Center for Global Health and Medicine Toyama 1‐21‐1, Shinjuku‐ku Tokyo 162‐8655 Japan
| | - Michi Kobayashi
- Department of Diabetes, Endocrinology and Metabolism National Center for Global Health and Medicine Toyama 1‐21‐1, Shinjuku‐ku Tokyo 162‐8655 Japan
| | - Sayaka Hikida
- Disease Control and Prevention Center National Center for Global Health and Medicine Toyama 1‐21‐1, Shinjuku‐ku Tokyo 162‐8655 Japan
| | - Yutaro Akiyama
- Disease Control and Prevention Center National Center for Global Health and Medicine Toyama 1‐21‐1, Shinjuku‐ku Tokyo 162‐8655 Japan
| | - Noriko Ihana‐Sugiyama
- Department of Diabetes, Endocrinology and Metabolism National Center for Global Health and Medicine Toyama 1‐21‐1, Shinjuku‐ku Tokyo 162‐8655 Japan
- Diabetes and Metabolism Information Center Research Institute National Center for Global Health and Medicine Toyama 1‐21‐1, Shinjuku‐ku Tokyo 162‐8655 Japan
| | - Mitsuru Osugi
- Department of Diabetes, Endocrinology and Metabolism National Center for Global Health and Medicine Toyama 1‐21‐1, Shinjuku‐ku Tokyo 162‐8655 Japan
- Diabetes and Metabolism Information Center Research Institute National Center for Global Health and Medicine Toyama 1‐21‐1, Shinjuku‐ku Tokyo 162‐8655 Japan
| | - Akiyo Tanabe
- Department of Diabetes, Endocrinology and Metabolism National Center for Global Health and Medicine Toyama 1‐21‐1, Shinjuku‐ku Tokyo 162‐8655 Japan
| | - Kojiro Ueki
- Department of Diabetes, Endocrinology and Metabolism National Center for Global Health and Medicine Toyama 1‐21‐1, Shinjuku‐ku Tokyo 162‐8655 Japan
- Department of Molecular Diabetic Medicine Diabetes Research Center Research Institute National Center for Global Health and Medicine Toyama 1‐21‐1, Shinjuku‐ku Tokyo 162‐8655 Japan
| | - Jin Takasaki
- Disease Control and Prevention Center National Center for Global Health and Medicine Toyama 1‐21‐1, Shinjuku‐ku Tokyo 162‐8655 Japan
- Department of Respiratory Medicine National Center for Global Health and Medicine Toyama 1‐21‐1, Shinjuku‐ku Tokyo 162‐8655 Japan
| | - Masayuki Hojo
- Department of Respiratory Medicine National Center for Global Health and Medicine Toyama 1‐21‐1, Shinjuku‐ku Tokyo 162‐8655 Japan
| | - Hiroshi Kajio
- Department of Diabetes, Endocrinology and Metabolism National Center for Global Health and Medicine Toyama 1‐21‐1, Shinjuku‐ku Tokyo 162‐8655 Japan
| |
Collapse
|
18
|
Terada-Hirashima J, Suzuki M, Tsujimoto Y, Hamamoto Y, Uemura Y, Tsushima K, Inoue H, Komatsu S, Saito Z, Tsuzuki R, Okamoto M, To Y, Moriya K, Yoshizawa S, Tanaka M, Muto T, Mikami A, Takasaki J, Izumi S, Ohmagari N, Hojo M, Sugiura W, Sugiyama H. Impact of inhaled ciclesonide on asymptomatic or mild COVID-19: A randomized trial. Drug Discov Ther 2022; 16:225-232. [DOI: 10.5582/ddt.2022.01068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Junko Terada-Hirashima
- Department of Respiratory Medicine, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Manabu Suzuki
- Department of Respiratory Medicine, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Yoshie Tsujimoto
- Department of Respiratory Medicine, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Yoichiro Hamamoto
- Department of Respiratory Medicine, National Hospital Organization Nishisaitama-Chuo National Hospital, Saitama, Japan
| | - Yukari Uemura
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kenji Tsushima
- International University of Health and Welfare, Narita Hospital, Chiba, Japan
| | - Hideki Inoue
- Respiratory/Allergy Internal Medicine, Showa University Hospital, Tokyo, Japan
| | - Shigeru Komatsu
- Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Kanagawa, Japan
| | - Zenya Saito
- Respiratory Medicine, Atsugi City Hospital, Kanagawa, Japan
| | - Ryuta Tsuzuki
- Allergy and Respiratory Medicine, The Fraternity Memorial Hospital, Tokyo, Japan
| | - Masaki Okamoto
- Department of Respirology and Clinical Research Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Yasuo To
- Respiratory Diseases Center, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Kyoji Moriya
- Infection Control and Prevention, The University of Tokyo Hospital, Tokyo, Japan
| | - Sadako Yoshizawa
- Department of Clinical Laboratory/Department of Microbiology and Infectious Diseases, Faculty of Medicine, Toho University, Tokyo Japan
| | - Masahide Tanaka
- Respiratory Medicine, National Hospital Organization Higashisaga Hospital, Saga, Japan
| | - Toshitaka Muto
- Hematology, National Hospital Organization Kokura Medical Center, Fukuoka, Japan
| | - Ayako Mikami
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Jin Takasaki
- Department of Respiratory Medicine, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinyu Izumi
- Department of Respiratory Medicine, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Masayuki Hojo
- Department of Respiratory Medicine, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Wataru Sugiura
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Haruhito Sugiyama
- Department of Respiratory Medicine, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| |
Collapse
|
19
|
Kalil AC, Mehta AK, Patterson TF, Erdmann N, Gomez CA, Jain MK, Wolfe CR, Ruiz-Palacios GM, Kline S, Regalado Pineda J, Luetkemeyer AF, Harkins MS, Jackson PEH, Iovine NM, Tapson VF, Oh MD, Whitaker JA, Mularski RA, Paules CI, Ince D, Takasaki J, Sweeney DA, Sandkovsky U, Wyles DL, Hohmann E, Grimes KA, Grossberg R, Laguio-Vila M, Lambert AA, Lopez de Castilla D, Kim E, Larson L, Wan CR, Traenkner JJ, Ponce PO, Patterson JE, Goepfert PA, Sofarelli TA, Mocherla S, Ko ER, Ponce de Leon A, Doernberg SB, Atmar RL, Maves RC, Dangond F, Ferreira J, Green M, Makowski M, Bonnett T, Beresnev T, Ghazaryan V, Dempsey W, Nayak SU, Dodd L, Tomashek KM, Beigel JH. Efficacy of interferon beta-1a plus remdesivir compared with remdesivir alone in hospitalised adults with COVID-19: a double-bind, randomised, placebo-controlled, phase 3 trial. Lancet Respir Med 2021; 9:1365-1376. [PMID: 34672949 PMCID: PMC8523116 DOI: 10.1016/s2213-2600(21)00384-2] [Citation(s) in RCA: 107] [Impact Index Per Article: 35.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/17/2021] [Accepted: 08/20/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Functional impairment of interferon, a natural antiviral component of the immune system, is associated with the pathogenesis and severity of COVID-19. We aimed to compare the efficacy of interferon beta-1a in combination with remdesivir compared with remdesivir alone in hospitalised patients with COVID-19. METHODS We did a double-blind, randomised, placebo-controlled trial at 63 hospitals across five countries (Japan, Mexico, Singapore, South Korea, and the USA). Eligible patients were hospitalised adults (aged ≥18 years) with SARS-CoV-2 infection, as confirmed by a positive RT-PCR test, and who met one of the following criteria suggestive of lower respiratory tract infection: the presence of radiographic infiltrates on imaging, a peripheral oxygen saturation on room air of 94% or less, or requiring supplemental oxygen. Patients were excluded if they had either an alanine aminotransferase or an aspartate aminotransferase concentration more than five times the upper limit of normal; had impaired renal function; were allergic to the study product; were pregnant or breast feeding; were already on mechanical ventilation; or were anticipating discharge from the hospital or transfer to another hospital within 72 h of enrolment. Patients were randomly assigned (1:1) to receive intravenous remdesivir as a 200 mg loading dose on day 1 followed by a 100 mg maintenance dose administered daily for up to 9 days and up to four doses of either 44 μg interferon beta-1a (interferon beta-1a group plus remdesivir group) or placebo (placebo plus remdesivir group) administered subcutaneously every other day. Randomisation was stratified by study site and disease severity at enrolment. Patients, investigators, and site staff were masked to interferon beta-1a and placebo treatment; remdesivir treatment was given to all patients without masking. The primary outcome was time to recovery, defined as the first day that a patient attained a category 1, 2, or 3 score on the eight-category ordinal scale within 28 days, assessed in the modified intention-to-treat population, defined as all randomised patients who were classified according to actual clinical severity. Safety was assessed in the as-treated population, defined as all patients who received at least one dose of the assigned treatment. This trial is registered with ClinicalTrials.gov, NCT04492475. FINDINGS Between Aug 5, 2020, and Nov 11, 2020, 969 patients were enrolled and randomly assigned to the interferon beta-1a plus remdesivir group (n=487) or to the placebo plus remdesivir group (n=482). The mean duration of symptoms before enrolment was 8·7 days (SD 4·4) in the interferon beta-1a plus remdesivir group and 8·5 days (SD 4·3) days in the placebo plus remdesivir group. Patients in both groups had a time to recovery of 5 days (95% CI not estimable) (rate ratio of interferon beta-1a plus remdesivir group vs placebo plus remdesivir 0·99 [95% CI 0·87-1·13]; p=0·88). The Kaplan-Meier estimate of mortality at 28 days was 5% (95% CI 3-7%) in the interferon beta-1a plus remdesivir group and 3% (2-6%) in the placebo plus remdesivir group (hazard ratio 1·33 [95% CI 0·69-2·55]; p=0·39). Patients who did not require high-flow oxygen at baseline were more likely to have at least one related adverse event in the interferon beta-1a plus remdesivir group (33 [7%] of 442 patients) than in the placebo plus remdesivir group (15 [3%] of 435). In patients who required high-flow oxygen at baseline, 24 (69%) of 35 had an adverse event and 21 (60%) had a serious adverse event in the interferon beta-1a plus remdesivir group compared with 13 (39%) of 33 who had an adverse event and eight (24%) who had a serious adverse event in the placebo plus remdesivir group. INTERPRETATION Interferon beta-1a plus remdesivir was not superior to remdesivir alone in hospitalised patients with COVID-19 pneumonia. Patients who required high-flow oxygen at baseline had worse outcomes after treatment with interferon beta-1a compared with those given placebo. FUNDING The National Institute of Allergy and Infectious Diseases (USA).
Collapse
Affiliation(s)
- Andre C Kalil
- University of Nebraska Medical Center, Omaha, NE, USA.
| | | | - Thomas F Patterson
- University of Texas Health San Antonio, University Health System, and the South Texas Veterans Health Care System, San Antonio, TX, USA
| | | | | | - Mamta K Jain
- University of Texas Southwestern Medical Center, Parkland Health & Hospital System, Dallas, TX, USA; UT Southwestern Medical Center, Parkland Health and Hospital System, Dallas, TX, USA
| | | | | | - Susan Kline
- University of Minnesota Medical School, Minneapolis, MN, USA
| | | | | | | | | | | | | | | | | | | | - Catharine I Paules
- Pennsylvania State Health Milton S Hershey Medical Center, Hershey, PA, USA
| | - Dilek Ince
- Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Jin Takasaki
- National Center for Global Health and Medicine, Tokyo, Japan
| | | | | | - David L Wyles
- Denver Health and Hospital Authority, Denver, CO, USA
| | | | | | - Robert Grossberg
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | | | | | | | - EuSuk Kim
- Seoul National University Bundang Hospital, Seongnam, Korea
| | - LuAnn Larson
- University of Nebraska Medical Center, Omaha, NE, USA
| | | | | | - Philip O Ponce
- University of Texas Health San Antonio, University Health System, and the South Texas Veterans Health Care System, San Antonio, TX, USA
| | - Jan E Patterson
- University of Texas Health San Antonio, University Health System, and the South Texas Veterans Health Care System, San Antonio, TX, USA
| | | | | | - Satish Mocherla
- University of Texas Southwestern Medical Center, Parkland Health & Hospital System, Dallas, TX, USA; UT Southwestern Medical Center, Parkland Health and Hospital System, Dallas, TX, USA
| | | | - Alfredo Ponce de Leon
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | | | - Ryan C Maves
- Naval Medical Center, San Diego, CA, USA; Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | | | | | | | | | - Tyler Bonnett
- Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Tatiana Beresnev
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - Varduhi Ghazaryan
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - Walla Dempsey
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - Seema U Nayak
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - Lori Dodd
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - Kay M Tomashek
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - John H Beigel
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| |
Collapse
|
20
|
Morita C, Suzuki M, Izumi S, Tsukada A, Tsujimoto Y, Sakamoto K, Hashimoto M, Takasaki J, Ohmagari N, Hojo M. Clinical outcomes of corticosteroids for COVID-19 patients at the National Center for Global Health and Medicine during the first wave of infections. Respir Investig 2021; 60:241-247. [PMID: 34872886 PMCID: PMC8616739 DOI: 10.1016/j.resinv.2021.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 11/03/2021] [Accepted: 11/04/2021] [Indexed: 12/15/2022]
Abstract
Background Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2, has been a significant concern worldwide since its outbreak in December 2019. Various treatments are being researched and developed, and there are reports that dexamethasone has reduced the mortality rate and improved the clinical course of critically ill patients with COVID-19. In this study, we examined the clinical efficacy of corticosteroid therapy for patients with COVID-19 in our hospital during the first wave of infections. Methods We retrospectively reviewed the medical records of patients with COVID-19 who were treated with or without corticosteroid therapy at the National Center for Global Health and Medicine in Japan between February and April 2020. The primary outcome was improvement in the patients’ clinical course using a seven-category ordinal scale. We collected data on patient characteristics, treatment, and clinical course, and compared them between two groups: the steroid-using group and the non-steroid-using group. Results Between February and April 2020, 110 patients were diagnosed with COVID-19. Despite poor conditions during admission into the steroid group, there were no statistical differences in clinical course between both groups, as measured using the scale. There were no statistical differences between the two groups in the number of days to fever resolution or negative polymerase chain reaction results. Conclusions There was no difference in the clinical course between both groups. Because of the difference in background, corticosteroids may potentially make the clinical course of severely ill patients similar to that of mildly ill patients.
Collapse
Affiliation(s)
- Chie Morita
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Manabu Suzuki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan.
| | - Shinyu Izumi
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Akinari Tsukada
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yoshie Tsujimoto
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Keita Sakamoto
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masao Hashimoto
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Jin Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norio Ohmagari
- Department of Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masayuki Hojo
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| |
Collapse
|
21
|
Hikida S, Morioka S, Fujii N, Tajima T, Terayama Y, Sugiura Y, Ishikane M, Takasaki J, Hojo M, Ohmagari N. A single-center descriptive study of untraced sources of infection among new cases of coronavirus disease in Tokyo, Japan. Glob Health Med 2021; 3:236-239. [PMID: 34532604 DOI: 10.35772/ghm.2021.01092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 08/09/2021] [Indexed: 11/08/2022]
Abstract
We investigated possible sources of newly infected patients with coronavirus disease (COVID-19) after the fourth wave in order to explore unknown sources. Retrospective chart review on all the confirmed patients with COVID-19 admitted to the National Center for Global Health and Medicine (NCGM) in Tokyo, Japan was conducted from May 22 through June 29, 2021. Among the 22 participants, 14 (64%) had a history of known high-risk infection behaviors. Of those, 12 reported that their activities involved eating and drinking. In addition, there were 24 high-risk situations, of those, 21 (88%) were related to indoor dining, and masks were not worn in 22 situations (92%). New source of infection has not been identified. In situations with a high known risk of infection, many cases were related to eating and drinking, and insufficient use of masks was evident. Raising risk awareness on infection prevention and control of COVID-19 is urgently needed.
Collapse
Affiliation(s)
- Sayaka Hikida
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Shinichiro Morioka
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan.,Emerging and Re-emerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan.,AMR Clinical Reference Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Naoki Fujii
- AMR Clinical Reference Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Taichi Tajima
- AMR Clinical Reference Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Yuriko Terayama
- Division of Respiratory Medicine, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Yuriko Sugiura
- Division of Respiratory Medicine, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Masahiro Ishikane
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan.,AMR Clinical Reference Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Jin Takasaki
- Division of Respiratory Medicine, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Masayuki Hojo
- Division of Respiratory Medicine, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan.,AMR Clinical Reference Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| |
Collapse
|
22
|
Nomoto H, Yamamoto K, Yamada G, Suzuki M, Kinoshita N, Takasaki J, Moriya A, Maeda K, Kimura M, Ohmagari N. Time-course evaluation of the quantitative antigen test for severe acute respiratory syndrome coronavirus 2: The potential contribution to alleviating isolation of COVID-19 patients. J Infect Chemother 2021; 27:1669-1673. [PMID: 34454833 PMCID: PMC8363432 DOI: 10.1016/j.jiac.2021.08.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 07/20/2021] [Accepted: 08/11/2021] [Indexed: 11/28/2022]
Abstract
Introduction The automated quantitative antigen test (QAT), which detects severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is suitable for mass screening. However, its diagnostic capability differentiated by time from onset and potential contribution to infectivity assessment have not been fully investigated. Methods A retrospective, observational study using nasopharyngeal swab specimens from coronavirus disease (COVID-19) inpatients was conducted using LumipulseⓇ SARS-CoV-2 antigen test. Diagnostic accuracy was examined for the early (up to 10 days after onset) and late (over 10 days after onset) stages. Time-course QAT changes and reverse‐transcription quantitative polymerase chain reaction tests results were displayed as locally estimated scatterplot smoothing curve, and receiver operating characteristic curve (ROC) analysis was used to determine the appropriate cutoff value for differentiating the early and late stages. Results We obtained 100 specimens from 68 COVID-19 patients, including 51 early-stage and 49 late-stage specimens. QAT sensitivity and specificity were 0.82 (0.72–0.90) and 0.95 (0.75–0.99) for all periods, 0.93 (0.82–0.98) and 1.00 (0.39–1.00) for the early stage, and 0.66 (0.48–0.82) and 0.93 (0.69–0.99) for the late stage, respectively. The ROC analysis indicated an ideal cutoff value of 6.93 pg/mL for distinguishing early-from late-stage specimens. The sensitivity, specificity, positive predictive value, and negative predictive value for predicting the late stage were 0.76 (0.61–0.87), 0.76 (0.63–0.87), 0.76 (0.61–0.87), and 0.76 (0.63–0.87). Conclusions QAT has favorable diagnostic accuracy in the early COVID-19 stages. In addition, an appropriate cutoff point can potentially facilitate rapid identification of noncontagious patients.
Collapse
Affiliation(s)
- Hidetoshi Nomoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan; Emerging and Reemerging Infectious Diseases, National Center for Global Health and Medicine, Graduate School of Medicine, Tohoku University, 2-1 Seiryo-cho, Aoba-ku, Sendai City, Miyagi 980-8575, Japan
| | - Kei Yamamoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
| | - Gen Yamada
- Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Michiyo Suzuki
- Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Noriko Kinoshita
- Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan; Emerging and Reemerging Infectious Diseases, National Center for Global Health and Medicine, Graduate School of Medicine, Tohoku University, 2-1 Seiryo-cho, Aoba-ku, Sendai City, Miyagi 980-8575, Japan
| | - Jin Takasaki
- Department of Respirology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Ataru Moriya
- Clinical Laboratory, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Kenji Maeda
- Department of Refractory Viral Infections, National Center for Global Health and Medicine Research Institute, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Motoi Kimura
- Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan; Emerging and Reemerging Infectious Diseases, National Center for Global Health and Medicine, Graduate School of Medicine, Tohoku University, 2-1 Seiryo-cho, Aoba-ku, Sendai City, Miyagi 980-8575, Japan
| |
Collapse
|
23
|
Tsukada A, Suzuki M, Kishino Y, Misumi K, Igari T, Nakajima N, Sato Y, Suzuki T, Katsuno T, Kusaba Y, Tsujimoto Y, Sakamoto K, Hashimoto M, Terada J, Takasaki J, Izumi S, Hojo M, Sugiyama H. A Kidney Transplant Patient Who Died of COVID-19-associated Severe Acute Respiratory Distress Syndrome. Intern Med 2021; 60:2297-2300. [PMID: 34053986 PMCID: PMC8355385 DOI: 10.2169/internalmedicine.7089-21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
We herein report a 67-year-old kidney transplant patient who died of COVID-19. He was treated with hydroxychloroquine and azithromycin and received mechanical ventilation that temporarily improved his respiratory status. Despite our efforts, however, he later developed respiratory failure and died 43 days after the disease onset. The autopsy revealed prominent organization of alveoli and alveolar ducts, with a massive accumulation of macrophages in the lungs. A few severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigen-positive cells were detected in the lung, suggesting delayed virus clearance owing to his long-term immunosuppressed state, leading to constant lung damage and ultimately respiratory failure.
Collapse
Affiliation(s)
- Akinari Tsukada
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Manabu Suzuki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Yuya Kishino
- Department of Diagnostic Pathology, National Center for Global Health and Medicine, Japan
| | - Kento Misumi
- Department of Diagnostic Pathology, National Center for Global Health and Medicine, Japan
| | - Toru Igari
- Department of Diagnostic Pathology, National Center for Global Health and Medicine, Japan
| | - Noriko Nakajima
- Department of Pathology, National Institute of Infectious Diseases, Japan
| | - Yuko Sato
- Department of Pathology, National Institute of Infectious Diseases, Japan
| | - Tadaki Suzuki
- Department of Pathology, National Institute of Infectious Diseases, Japan
| | - Takashi Katsuno
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Yusaku Kusaba
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Yoshie Tsujimoto
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Keita Sakamoto
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Masao Hashimoto
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Junko Terada
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Jin Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Shinyu Izumi
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Masayuki Hojo
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Haruhito Sugiyama
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| |
Collapse
|
24
|
Hirata N, Ngo DT, Phan PH, Ainai A, Phung TTB, Ta TA, Takasaki J, Kawachi S, Nunoi H, Nakajima N, Dien TM. Recombinant human thrombomodulin for pneumonia-induced severe ARDS complicated by DIC in children: a preliminary study. J Anesth 2021; 35:638-645. [PMID: 34259911 PMCID: PMC8278185 DOI: 10.1007/s00540-021-02971-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 07/02/2021] [Indexed: 12/15/2022]
Abstract
Purpose Recombinant human soluble thrombomodulin (rTM) has been used to treat disseminated intravascular coagulation (DIC). Recent studies have shown the efficacy of rTM through its anti-inflammatory effects for treatment of adults with acute respiratory distress syndrome (ARDS). However, the safety and efficacy of rTM in children with severe ARDS complicated by DIC have not been reported. In this preliminary study, we reported the feasibility of using rTM for the treatment of pneumonia-induced severe ARDS complicated by DIC in children. Methods Six children (age: median 10 months old) with pneumonia-induced severe ARDS complicated by DIC were enrolled in this preliminary study. rTM (380 U/kg) was administered for a maximum of 6 days, in addition to conventional therapies after diagnosis of severe ARDS complicated by DIC. After administration of rTM, we measured changes in the plasma TM concentration and evaluated the clinical course, status of DIC and ARDS, and other laboratory findings, including levels of cytokines, chemokines, and biomarkers. Results In all six children, the plasma concentration of TM increased and DIC scores decreased after administration of rTM. Four of the six children recovered from the severe ARDS complicated by DIC after treatment, and were discharged from the hospital with no complications. In survived children, levels of soluble receptors for advanced glycation end products, interleukin-6, interleukin-8 and monocyte chemotactic protein-1 decreased after administration of rTM compared to those before rTM. Conclusions The rTM administration is feasible as an adjunctive therapeutic strategy for children over 2 months with pneumonia-induced severe ARDS complicated by DIC. Supplementary Information The online version contains supplementary material available at 10.1007/s00540-021-02971-3.
Collapse
Affiliation(s)
- Naoyuki Hirata
- Department of Anesthesiology, Sapporo Medical University School of Medicine, S1 W16 Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan.
| | - Dong Tien Ngo
- Department of Pediatrics Intensive Care Units, National Children's Hospital, 18 ngõ 879 Đường La Thành, Láng Thượng, Đống Đa, Hanoi, Vietnam
| | - Phuc Huu Phan
- Department of Pediatrics Intensive Care Units, National Children's Hospital, 18 ngõ 879 Đường La Thành, Láng Thượng, Đống Đa, Hanoi, Vietnam
| | - Akira Ainai
- Department of Pathology, National Institute of Infectious Diseases, 1-23-1, Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan
| | - Thuy Thi Bich Phung
- Department of Molecular Biology for Infectious Disease, National Children's Hospital, 18 ngõ 879 Đường La Thành, Láng Thượng, Đống Đa, Hanoi, Vietnam
| | - Tuan Anh Ta
- Department of Pediatrics Intensive Care Units, National Children's Hospital, 18 ngõ 879 Đường La Thành, Láng Thượng, Đống Đa, Hanoi, Vietnam
| | - Jin Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku-ku, Tokyo, 162-8622, Japan
| | - Shoji Kawachi
- Division of the Asia International Institute of Infection Disease Control, Teikyo University, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605, Japan
| | - Hiroyuki Nunoi
- Aisenkai Nichinan Hospital, 3649-2 Kazeta, Nichinan, Miyazaki, 887-0034, Japan
| | - Noriko Nakajima
- Department of Pathology, National Institute of Infectious Diseases, 1-23-1, Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan
| | - Tran Minh Dien
- Department of Surgical Intensive Care Unit, National Children's Hospital, 18 ngõ 879 Đường La Thành, Láng Thượng, Đống Đa, Hanoi, Vietnam
| |
Collapse
|
25
|
Akiyama Y, Kinoshita N, Sadamasu K, Nagashima M, Yoshida I, Kusaba Y, Suzuki T, Nagashima M, Ishikane M, Takasaki J, Yoshimura K, Ohmagari N. A pilot study of viral load in stools of patients with COVID-19 and diarrhea. Jpn J Infect Dis 2021; 75:36-40. [PMID: 34053956 DOI: 10.7883/yoken.jjid.2021.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
It is known that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can be detected in the stools of patients with the coronavirus disease 2019 (COVID-19) and that the virus can be transmitted by oral-fecal route. However, there are few reports on the viral load in stools. This pilot study aimed to evaluate the clinical characteristics and viral load of SARS-CoV-2 in the stools of 13 patients with confirmed COVID-19 using as control the pepper mild mottle virus, which was proposed as a potential indicator of human fecal contamination of environmental water. SARS-CoV-2 RNA was detected in stool samples from four patients (31%), among whom three presented diarrhea symptoms. One patient experiencing long-term diarrhea (22 days) had high levels of viral RNA in the stools (8.28 log10 copies/g). However, we could not isolate the SARS-CoV-2 in the stool of any patients, using VeroE6/TMPRESS2 cells for four weeks. Our results suggest that SARS-CoV-2 RNA may be detected in the stools of patients with the diarrhea symptoms. Further studies evaluating the relationship between SARS-CoV-2 viral load in stools and diarrhea symptoms in larger patient cohorts and upon adjusting for other causative factors and virus infectivity are still needed.
Collapse
Affiliation(s)
- Yutaro Akiyama
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Noriko Kinoshita
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Kenji Sadamasu
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Japan
| | - Mami Nagashima
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Japan
| | - Isao Yoshida
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Japan
| | - Yusaku Kusaba
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Tetsuya Suzuki
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Maki Nagashima
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Masahiro Ishikane
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Jin Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Kazuhisa Yoshimura
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Japan
| | - Norio Ohmagari
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| |
Collapse
|
26
|
Yamamoto K, Nagashima M, Yoshida I, Sadamasu K, Kurokawa M, Nagashima M, Kinoshita N, Maeda K, Takasaki J, Teruya K, Ohmagari N. Does the SARS-CoV-2 rapid antigen test result correlate with the viral culture result? J Infect Chemother 2021; 27:1273-1275. [PMID: 34023222 PMCID: PMC8114766 DOI: 10.1016/j.jiac.2021.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/24/2021] [Accepted: 05/07/2021] [Indexed: 11/28/2022]
Abstract
Rapid antigen tests (RATs) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have advantages over viral culture in terms of cost and rapidity of testing, but they have low sensitivity. In addition, RATs tend to be negative from approximately 11 days after symptom onset. To determine whether the antigen-negative state indicates a lack of infectiousness, we assessed the association between viral culture and RAT results. Viral culture, reverse transcription-quantitative polymerase chain reaction (RT-qPCR), and rapid antigen testing were performed on stored nasopharyngeal samples with threshold cycle values < 30, based on previous RT-qPCR testing. SARS-CoV-2 was isolated by viral culture from nine samples (45%) and one sample (17%) with positive and negative RAT results, respectively. The RAT and viral culture results were both associated with the viral load level and their cutoffs were similar, but the associations were not statistically significant. RAT might be a useful indicator of infectiousness, which can be helpful to control infection. However, further studies with larger sample size are warranted to confirm this observation.
Collapse
Affiliation(s)
- Kei Yamamoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, 162-8655, Japan.
| | - Mami Nagashima
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Tokyo, 169-0073, Japan.
| | - Isao Yoshida
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Tokyo, 169-0073, Japan.
| | - Kenji Sadamasu
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Tokyo, 169-0073, Japan.
| | - Masami Kurokawa
- Clinical Laboratory, National Center for Global Health and Medicine, Tokyo, 162-8655, Japan.
| | - Maki Nagashima
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, 162-8655, Japan.
| | - Noriko Kinoshita
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, 162-8655, Japan.
| | - Kenji Maeda
- Department of Refractory Viral Infections, National Center for Global Health and Medicine Research Institute, Tokyo, 162-0052, Japan.
| | - Jin Takasaki
- Department of Respirology, National Center for Global Health and Medicine, Tokyo, 162-8655, Japan.
| | - Katsuji Teruya
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, 162-8655, Japan.
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, 162-8655, Japan.
| |
Collapse
|
27
|
Tsujimoto Y, Terada J, Kimura M, Moriya A, Motohashi A, Izumi S, Kawajiri K, Hakkaku K, Morishita M, Saito S, Takumida H, Watanabe H, Tsukada A, Morita C, Yamaguchi Y, Katsuno T, Kusaba Y, Sakamoto K, Hashimoto M, Suzuki M, Takasaki J, Hojo M, Miyoshi-Akiyama T, Sugiyama H. Diagnostic accuracy of nasopharyngeal swab, nasal swab and saliva swab samples for the detection of SARS-CoV-2 using RT-PCR. Infect Dis (Lond) 2021; 53:581-589. [PMID: 33760699 PMCID: PMC8006266 DOI: 10.1080/23744235.2021.1903550] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background The current gold standard in coronavirus disease (COVID-19) diagnostics is the real-time reverse transcription–polymerase chain reaction (RT-PCR) assay for detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in nasopharyngeal swab (NPS) samples. Alternatively, nasal swab (NS) or saliva swab (SS) specimens are used, although available data on test accuracy are limited. We examined the diagnostic accuracy of NPS/NS/SS samples for this purpose. Methods Ten patients were included after being tested positive for SARS-CoV-2 RT-PCR in NPS samples according to the National Institute of Infectious Disease guidelines. In comparison with this conventional diagnostic method, NPS/NS/SS samples were tested using the cobas 6800 systems RT-PCR device. To investigate the usefulness of the cobas method and the difference among sample types, the agreement and sensitivity were calculated. Five to six samples were collected over a total period of 5–6 d from each patient. Results Fifty-seven sets of NPS/NS/SS samples were collected, of which 40 tested positive for COVID-19 by the conventional method. Overall, the concordance rates using the conventional method were 86.0%/70.2%/54.4% for NPS/NS/SS samples (cobas); however, for samples collected up to and including on Day 9 after disease onset (22 negative and one positive specimens), the corresponding rates were 95.7%/87.0%/65.2%. The overall sensitivity estimates were 100.0%/67.5%/37.5% for NPS/NS/SS samples (cobas). For samples up to 9 d after onset, the corresponding values were 100.0%/86.4%/63.6%. Conclusions NS samples are more reliable than SS samples and can be an alternative to NPS samples. They can be a useful diagnostic method in the future.
Collapse
Affiliation(s)
- Yoshie Tsujimoto
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Junko Terada
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Moto Kimura
- Center for Clinical Science, National National Center for Global Health and Medicine, Tokyo, Japan
| | - Ataru Moriya
- Laboratory Testing Department, National Center for Global Health and Medicine, Tokyo, Japan
| | - Ayano Motohashi
- Laboratory Testing Department, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinyu Izumi
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kazuki Kawajiri
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kazuo Hakkaku
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Momoko Morishita
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Susumu Saito
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiroshi Takumida
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiromu Watanabe
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Akinari Tsukada
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Chie Morita
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yoh Yamaguchi
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takashi Katsuno
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yusaku Kusaba
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Keita Sakamoto
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masao Hashimoto
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Manabu Suzuki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Jin Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masayuki Hojo
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tohru Miyoshi-Akiyama
- Department of Infectious Disease, National Center for Global Health and Medicine, Tokyo, Japan
| | - Haruhito Sugiyama
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| |
Collapse
|
28
|
Kutsuna S, Asai Y, Matsunaga A, Kinoshita N, Terada M, Miyazato Y, Nakamoto T, Suzuki T, Saito S, Endo M, Kanda K, Kenji M, Takasaki J, Hojo M, Ishizaka Y, Ohmagari N. Factors associated with anti-SARS-CoV-2 IgG antibody production in patients convalescing from COVID-19. J Infect Chemother 2021; 27:808-813. [PMID: 33531292 PMCID: PMC7836855 DOI: 10.1016/j.jiac.2021.01.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 12/01/2020] [Accepted: 01/12/2021] [Indexed: 02/07/2023]
Abstract
Introduction Among patients with coronavirus disease 2019 (COVID-19), the factors that affect anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody production remain unclear. This study aimed to identify such factors among patients convalescing from COVID-19. Methods This study comprised patients who had been diagnosed with COVID-19 between January 1 and June 30, 2020 and gave consent for anti-SARS-CoV-2 spike protein antibody measurement using enzyme-linked immunosorbent assay during their acute and/or convalescent phases. Factors related to elevated antibody titers and the relationship between the days from disease onset and the development of antibody titers were assessed. Results A total of 84 participants enrolled in the study. Nineteen participants had antibody titers measured during the convalescent phase only, and 65 participants had antibody titers measured during the acute and convalescent phases. The antibody titers peaked in weeks 5 and 6. The stepwise multivariate log-normal analysis revealed that male sex (P = 0.04), diabetes mellitus (P = 0.03), and high C-reactive protein levels during the disease course (P < 0.001) were associated with elevated IgG antibodies. Glucocorticoid use was not associated with antibody titers. Conclusion The study found that high values of maximum CRP levels during the acute phase, male sex, and diabetes mellitus were associated with elevated antibody titers. Antibody titers tended to be highest in the first 5 or 6 weeks after the onset of symptoms.
Collapse
Affiliation(s)
- Satoshi Kutsuna
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan.
| | - Yusuke Asai
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Akihiro Matsunaga
- Department of Intractable Diseases, National Center for Global Health and Medicine, Tokyo, Japan
| | - Noriko Kinoshita
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Mari Terada
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yusuke Miyazato
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takato Nakamoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tetsuya Suzuki
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Sho Saito
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan.
| | - Mio Endo
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kohei Kanda
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Maeda Kenji
- Department of Refractory Viral Infections, National Center for Global Health and Medicine Research Institute, Tokyo, Japan
| | - Jin Takasaki
- Department of Respiratory Diseases, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masayuki Hojo
- Department of Respiratory Diseases, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yukihito Ishizaka
- Department of Intractable Diseases, National Center for Global Health and Medicine, Tokyo, Japan; Vice Director-General, National Center for Global Health and Medicine Research Institute, Tokyo, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| |
Collapse
|
29
|
Sugiyama M, Kinoshita N, Ide S, Nomoto H, Nakamoto T, Saito S, Ishikane M, Kutsuna S, Hayakawa K, Hashimoto M, Suzuki M, Izumi S, Hojo M, Tsuchiya K, Gatanaga H, Takasaki J, Usami M, Kano T, Yanai H, Nishida N, Kanto T, Sugiyama H, Ohmagari N, Mizokami M. Serum CCL17 level becomes a predictive marker to distinguish between mild/moderate and severe/critical disease in patients with COVID-19. Gene 2021; 766:145145. [PMID: 32941953 PMCID: PMC7489253 DOI: 10.1016/j.gene.2020.145145] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 09/04/2020] [Accepted: 09/09/2020] [Indexed: 01/08/2023]
Abstract
COVID-19, a novel coronavirus-related illness, has spread worldwide. Patients with apparently mild/moderate symptoms can suddenly develop severe pneumonia. Therefore, almost all COVID-19 patients require hospitalization, which can reduce limited medical resources in addition to overwhelming medical facilities. To identify predictive markers for the development of severe pneumonia, a comprehensive analysis of serum chemokines and cytokines was conducted using serial serum samples from COVID-19 patients. The expression profiles were analyzed along the time axis. Serum samples of common diseases were enrolled from a BioBank to confirm the usefulness of predictive markers. Five factors, IFN-λ3, IL-6, IP-10, CXCL9, and CCL17, were identified as predicting the onset of severe/critical symptoms. The factors were classified into two categories. Category A included IFN-λ3, IL-6, IP-10, and CXCL9, and their values surged and decreased rapidly before the onset of severe pneumonia. Category B included CCL17, which provided complete separation between the mild/moderate and the severe/critical groups at an early phase of SARS-CoV-2 infection. The five markers provided a high predictive value (area under the receiver operating characteristic curve (AUROC): 0.9-1.0, p < 0.001). Low expression of CCL17 was specifically observed in pre-severe COVID-19 patients compared with other common diseases, and the predictive ability of CCL17 was confirmed in validation samples of COVID-19. The factors identified could be promising prognostic markers to distinguish between mild/moderate and severe/critical patients, enabling triage at an early phase of infection, thus avoiding overwhelming medical facilities.
Collapse
Affiliation(s)
- Masaya Sugiyama
- Genome Medical Sciences Project, National Center for Global Health and Medicine, 1-7-1 Kohnodai, Ichikawa, Chiba 272-8516, Japan.
| | - Noriko Kinoshita
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Satoshi Ide
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Hidetoshi Nomoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Takato Nakamoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Sho Saito
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Masahiro Ishikane
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Satoshi Kutsuna
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Kayoko Hayakawa
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Masao Hashimoto
- Department of Respiratory Medicine, National Center for Global Health and Medicine Hospital, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Manabu Suzuki
- Department of Respiratory Medicine, National Center for Global Health and Medicine Hospital, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Shinyu Izumi
- Department of Respiratory Medicine, National Center for Global Health and Medicine Hospital, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Masayuki Hojo
- Department of Respiratory Medicine, National Center for Global Health and Medicine Hospital, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Kiyoto Tsuchiya
- AIDS Clinical Center, National Center for Global Health and Medicine Hospital, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Hiroyuki Gatanaga
- AIDS Clinical Center, National Center for Global Health and Medicine Hospital, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Jin Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine Hospital, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Masahide Usami
- Department of Child and Adolescent Psychiatry, National Center for Global Health and Medicine, 1-7-1 Kohnodai, Ichikawa, Chiba 272-8516, Japan
| | - Toshikazu Kano
- Department of Rheumatism and Collagen Diseases, National Center for Global Health and Medicine, 1-7-1 Kohnodai, Ichikawa, Chiba 272-8516, Japan
| | - Hidekatsu Yanai
- Department of Internal Medicine, Kohnodai Hospital, National Center for Global Health and Medicine, 1-7-1 Kohnodai, Ichikawa, Chiba 272-8516, Japan
| | - Nao Nishida
- Genome Medical Sciences Project, National Center for Global Health and Medicine, 1-7-1 Kohnodai, Ichikawa, Chiba 272-8516, Japan
| | - Tatsuya Kanto
- The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, 1-7-1, Kohnodai, Ichikawa, Chiba, 272-8516, Japan
| | - Haruhito Sugiyama
- Department of Respiratory Medicine, National Center for Global Health and Medicine Hospital, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan.
| | - Masashi Mizokami
- Genome Medical Sciences Project, National Center for Global Health and Medicine, 1-7-1 Kohnodai, Ichikawa, Chiba 272-8516, Japan
| |
Collapse
|
30
|
Katagiri D, Ishikane M, Asai Y, Izumi S, Takasaki J, Katsuoka H, Kondo I, Ide S, Nakamura K, Nakamoto T, Nomoto H, Akiyama Y, Miyazato Y, Suzuki T, Kinoshita N, Ogawa T, Togano T, Suzuki M, Hashimoto M, Sakamoto K, Kusaba Y, Katsuno T, Fukaya T, Hojo M, Sugiyama M, Mizokami M, Okamoto T, Kimura A, Noiri E, Ohmagari N, Hinoshita F, Sugiyama H. Direct hemoperfusion using a polymyxin B-immobilized polystyrene column for COVID-19. J Clin Apher 2020; 36:313-321. [PMID: 33325084 PMCID: PMC8246724 DOI: 10.1002/jca.21861] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/09/2020] [Accepted: 11/13/2020] [Indexed: 12/13/2022]
Abstract
Objective To evaluate the efficacy and safety of direct hemoperfusion using a polymyxin B‐immobilized polystyrene column (PMX‐DHP) in severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2)‐positive pneumonia patients. Methods This study was a case series conducted at a designated infectious diseases hospital. Twelve SARS‐CoV‐2‐positive patients with partial pressure of arterial oxygen/percentage of inspired oxygen (P/F) ratio < 300 were treated with PMX‐DHP on two consecutive days each during hospitalization. We defined day 1 as the first day when PMX‐DHP was performed. PMX‐DHP efficacy was assessed on days 7 and 14 after the first treatment based on eight categories. Subsequently, improvement in P/F ratio and urinary biomarkers on days 4 and 8, malfunctions, and ventilator and extracorporeal membrane oxygenation avoidance rates were also evaluated. Results On day 14 after the first treatment, disease severity decreased in 58.3% of the patients. P/F ratio increased while urine β2‐microglobulin decreased on days 4 and 8. Cytokine measurement pre‐ and post‐PMX‐DHP revealed decreased levels of interleukin‐6 and the factors involved in vascular endothelial injury, including vascular endothelial growth factor. Twenty‐two PMX‐DHPs were performed, of which seven and five PMX‐DHPs led to increased inlet pressure and membrane coagulation, respectively. When the membranes coagulated, the circuitry needed to be reconfigured. Circuit problems were usually observed when D‐dimer and fibrin degradation product levels were high before PMX‐DHP. Conclusions Future studies are expected to determine the therapeutic effect of PMX‐DHP on COVID‐19. Because of the relatively high risk of circuit coagulation, coagulation capacity should be assessed beforehand.
Collapse
Affiliation(s)
- Daisuke Katagiri
- Department of Nephrology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masahiro Ishikane
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yusuke Asai
- Antimicrobial Resistance Clinical Reference Center, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinyu Izumi
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Jin Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiyori Katsuoka
- Medical Equipment Management Office, National Center for Global Health and Medicine, Tokyo, Japan
| | - Isao Kondo
- Department of Nephrology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Satoshi Ide
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Keiji Nakamura
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takato Nakamoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hidetoshi Nomoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yutaro Akiyama
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yusuke Miyazato
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tetsuya Suzuki
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Noriko Kinoshita
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tatsunori Ogawa
- Medical Equipment Management Office, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tomiteru Togano
- Department of Hematology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Manabu Suzuki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masao Hashimoto
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Keita Sakamoto
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yusaku Kusaba
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takashi Katsuno
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takashi Fukaya
- Medical Equipment Management Office, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masayuki Hojo
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masaya Sugiyama
- Genome Medical Sciences Project, Research Institute, National Center for Global Health and Medicine, Ichikawa, Japan
| | - Masashi Mizokami
- Genome Medical Sciences Project, Research Institute, National Center for Global Health and Medicine, Ichikawa, Japan
| | - Tatsuya Okamoto
- Department of Intensive Care Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Akio Kimura
- Department of Emergency Medicine and Critical Care, National Center for Global Health and Medicine, Tokyo, Japan
| | - Eisei Noiri
- National Center Biobank Network, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Fumihiko Hinoshita
- Department of Nephrology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Haruhito Sugiyama
- National Center Biobank Network, National Center for Global Health and Medicine, Tokyo, Japan
| |
Collapse
|
31
|
Kusaba Y, Izumi S, Takasaki J, Suzuki M, Katagiri D, Katsuno T, Matsumoto S, Sakamoto K, Hashimoto M, Ohmagari N, Katano H, Suzuki T, Hojo M, Sugiyama H. Successful Recovery from COVID-19-associated Acute Respiratory Failure with Polymyxin B-immobilized Fiber Column-direct Hemoperfusion. Intern Med 2020; 59:2405-2408. [PMID: 32863364 PMCID: PMC7644505 DOI: 10.2169/internalmedicine.5413-20] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
An 83-year-old man was hospitalized for coronavirus disease 2019 (COVID-19) after a 10-day history of a persistent fever. Chest computed tomography showed extensive non-segmental ground glass opacity. Despite the initiation of lopinavir and ritonavir, respiratory failure progressed. Two days of polymyxin B-immobilized fiber column-direct hemoperfusion (PMX-DHP) with adjunctive corticosteroid prevented his respiratory condition from worsening. For rapidly progressive COVID-19 cases, the early use of PMX-DHP may avoid the need for mechanical ventilation by suppressing local inflammation of the lung.
Collapse
Affiliation(s)
- Yusaku Kusaba
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Shinyu Izumi
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Jin Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Manabu Suzuki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Daisuke Katagiri
- Department of Nephrology, National Center for Global Health and Medicine, Japan
| | - Takashi Katsuno
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Shuichiro Matsumoto
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Keita Sakamoto
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Masao Hashimoto
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Norio Ohmagari
- Diseases Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Harutaka Katano
- Department of Pathology, National Institute of Infectious Diseases, Japan
| | - Tadaki Suzuki
- Department of Pathology, National Institute of Infectious Diseases, Japan
| | - Masayuki Hojo
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Haruhito Sugiyama
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| |
Collapse
|
32
|
Yamamoto K, Saito S, Hayakawa K, Hashimoto M, Takasaki J, Ohmagari N. When Clinicians Should Repeat RT-PCR for SARS-CoV-2: Repeat PCR Testing in Patients with Pulmonary CT Findings Suggestive of COVID-19. Jpn J Infect Dis 2020; 74:161-165. [PMID: 32863359 DOI: 10.7883/yoken.jjid.2020.531] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Real-time reverse transcription polymerase chain reaction (RT-PCR) tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are occasionally repeated when clinicians suspect false-negative results, but the conditions under which repeated RT-PCR testing is warranted remain unclear. We evaluated the practice of repeat RT-PCR testing for SARS-CoV-2 in 45 patients who were retested after an initial negative PCR test. Of these, the diagnosis of coronavirus disease (COVID-19) was confirmed in four patients with typical chest computed tomography (CT) findings and in one patient without typical CT findings in whom the test result was strongly suspected to be false-positive. We recommend repeat RT-PCR testing only for patients with typical CT findings of COVID-19.
Collapse
Affiliation(s)
- Kei Yamamoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Sho Saito
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Kayoko Hayakawa
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Masao Hashimoto
- Department of Respirology, National Center for Global Health and Medicine, Japan
| | - Jin Takasaki
- Department of Respirology, National Center for Global Health and Medicine, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| |
Collapse
|
33
|
Ueki Y, Suzuki M, Horikawa Y, Watanabe H, Yamaguchi Y, Morita C, Tsukada A, Takumida H, Kusaba Y, Katsuno T, Tsujimoto Y, Sakamoto K, Hashimoto M, Terada J, Ishii S, Takasaki J, Naka G, Iikura M, Izumi S, Takeda Y, Hojo M, Sugiyama H. Pembrolizumab-induced pancytopenia in a patient with squamous cell lung cancer. Thorac Cancer 2020; 11:2731-2735. [PMID: 32767641 PMCID: PMC7471020 DOI: 10.1111/1759-7714.13582] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/27/2020] [Accepted: 06/30/2020] [Indexed: 11/29/2022] Open
Abstract
Immune checkpoint inhibitors (ICIs) are reportedly effective against many kinds of neoplasm, but may be responsible for several kinds of immune‐related adverse events (irAEs). Among these irAEs, the incidence of myelosuppression due to ICIs is relatively low. Corticosteroids are needed to control most cases of myelosuppression. Here, we report an 88‐year‐old woman with squamous cell lung cancer who was administered pembrolizumab. After five cycles of pembrolizumab, she developed severe pancytopenia. The pancytopenia improved under observation without steroid administration after cessation of pembrolizumab. During recovery from this irAE, the patient also maintained long‐term antitumor efficacy. Key points Significant findings of the study There are several kinds of immune‐related adverse events. We encountered a case of pembrolizumab‐induced pancytopenia with squamous cell lung cancer. What this study adds Corticosteroids are needed to control most cases of myelosuppression induced by ICIs, but pancytopenia induced by pembrolizumab in our case improved without steroids.
Collapse
Affiliation(s)
- Yuriko Ueki
- Department of Respiratory Medicine, National Centre for Global Health and Medicine, Shinjuku-ku, Japan
| | - Manabu Suzuki
- Department of Respiratory Medicine, National Centre for Global Health and Medicine, Shinjuku-ku, Japan
| | - Yuriko Horikawa
- Department of Respiratory Medicine, National Centre for Global Health and Medicine, Shinjuku-ku, Japan
| | - Hiromu Watanabe
- Department of Respiratory Medicine, National Centre for Global Health and Medicine, Shinjuku-ku, Japan
| | - Yoh Yamaguchi
- Department of Respiratory Medicine, National Centre for Global Health and Medicine, Shinjuku-ku, Japan
| | - Chie Morita
- Department of Respiratory Medicine, National Centre for Global Health and Medicine, Shinjuku-ku, Japan
| | - Akinari Tsukada
- Department of Respiratory Medicine, National Centre for Global Health and Medicine, Shinjuku-ku, Japan
| | - Hiroshi Takumida
- Department of Respiratory Medicine, National Centre for Global Health and Medicine, Shinjuku-ku, Japan
| | - Yusaku Kusaba
- Department of Respiratory Medicine, National Centre for Global Health and Medicine, Shinjuku-ku, Japan
| | - Takashi Katsuno
- Department of Respiratory Medicine, National Centre for Global Health and Medicine, Shinjuku-ku, Japan
| | - Yoshie Tsujimoto
- Department of Respiratory Medicine, National Centre for Global Health and Medicine, Shinjuku-ku, Japan
| | - Keita Sakamoto
- Department of Respiratory Medicine, National Centre for Global Health and Medicine, Shinjuku-ku, Japan
| | - Masao Hashimoto
- Department of Respiratory Medicine, National Centre for Global Health and Medicine, Shinjuku-ku, Japan
| | - Junko Terada
- Department of Respiratory Medicine, National Centre for Global Health and Medicine, Shinjuku-ku, Japan
| | - Satoru Ishii
- Department of Respiratory Medicine, National Centre for Global Health and Medicine, Shinjuku-ku, Japan
| | - Jin Takasaki
- Department of Respiratory Medicine, National Centre for Global Health and Medicine, Shinjuku-ku, Japan
| | - Go Naka
- Department of Respiratory Medicine, National Centre for Global Health and Medicine, Shinjuku-ku, Japan
| | - Motoyasu Iikura
- Department of Respiratory Medicine, National Centre for Global Health and Medicine, Shinjuku-ku, Japan
| | - Shinyu Izumi
- Department of Respiratory Medicine, National Centre for Global Health and Medicine, Shinjuku-ku, Japan
| | - Yuichiro Takeda
- Department of Respiratory Medicine, National Centre for Global Health and Medicine, Shinjuku-ku, Japan
| | - Masayuki Hojo
- Department of Respiratory Medicine, National Centre for Global Health and Medicine, Shinjuku-ku, Japan
| | - Haruhito Sugiyama
- Department of Respiratory Medicine, National Centre for Global Health and Medicine, Shinjuku-ku, Japan
| |
Collapse
|
34
|
Ishii S, Suzuki M, Arai H, Takasaki J, Hojo M, Sugiyama H. Use of pleural cryobiopsy for tissue culture specimens: a case report. Respirol Case Rep 2020; 8:e00593. [PMID: 32514353 PMCID: PMC7273824 DOI: 10.1002/rcr2.593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 05/14/2020] [Accepted: 05/17/2020] [Indexed: 11/10/2022] Open
Abstract
A 43‐year‐old man presented with cough. His chest X‐ray showed a left‐sided pleural effusion. We suspected tuberculous pleurisy (TP), and thoracoscopy under local anaesthesia was performed. It showed entire pleura with scattered nodules. Nodules were biopsied by conventional biopsy forceps, but the tissue sample was small. Therefore, the nodules were biopsied with a cryoprobe. The tissue size obtained was 2 mm by conventional biopsy forceps, and 6 mm at 5 sec by cryobiopsy. Histological analysis of the conventional biopsy forceps and cryobiopsy specimen showed inflammation with lymphocytes and caseating granulomas. Tissue culture of conventional biopsy forceps was positive for Mycobacterium tuberculosis, and all sensitivity tests were positive. But, the tissue culture of the cryobiopsy sample was negative. There is a possibility that cryobiopsy is not useful for tissue culture for TP.
Collapse
Affiliation(s)
- Satoru Ishii
- Department of Respiratory MedicineNational Center for Global Health and Medicine Tokyo Japan
| | - Manabu Suzuki
- Department of Respiratory MedicineNational Center for Global Health and Medicine Tokyo Japan
| | - Hirokazu Arai
- Department of Respiratory MedicineNational Center for Global Health and Medicine Tokyo Japan
| | - Jin Takasaki
- Department of Respiratory MedicineNational Center for Global Health and Medicine Tokyo Japan
| | - Masayuki Hojo
- Department of Respiratory MedicineNational Center for Global Health and Medicine Tokyo Japan
| | - Haruhito Sugiyama
- Department of Respiratory MedicineNational Center for Global Health and Medicine Tokyo Japan
| |
Collapse
|
35
|
Katsuno T, Suzuki M, Ishikane M, Kinoshita N, Tsukada A, Morita C, Kusaba Y, Sakamoto K, Yamaguchi Y, Tsujimoto Y, Hashimoto M, Terada J, Takasaki J, Izumi S, Okuhama A, Ide S, Moriyama Y, Matsuda K, Takamatsu Y, Mitsuya H, Hojo M, Sugiyama H. A familial cluster of severe coronavirus disease 2019 that required intubation of all family members. Infect Dis (Lond) 2020; 52:755-758. [PMID: 32615051 DOI: 10.1080/23744235.2020.1784999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- Takashi Katsuno
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Manabu Suzuki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masahiro Ishikane
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Noriko Kinoshita
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Akinari Tsukada
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Chie Morita
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yusaku Kusaba
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Keita Sakamoto
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yoh Yamaguchi
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yoshie Tsujimoto
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masao Hashimoto
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Junko Terada
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Jin Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinyu Izumi
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Ayako Okuhama
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Satoshi Ide
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yuki Moriyama
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kouki Matsuda
- Department of Refractory Viral Infections, Research Institute National Center for Global Health and Medicine, Tokyo, Japan
| | - Yuki Takamatsu
- Department of Refractory Viral Infections, Research Institute National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiroaki Mitsuya
- Department of Refractory Viral Infections, Research Institute National Center for Global Health and Medicine, Tokyo, Japan
| | - Masayuki Hojo
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Haruhito Sugiyama
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| |
Collapse
|
36
|
Morioka S, Saito S, Hayakawa K, Takasaki J, Suzuki T, Ide S, Nakamura K, Moriyama Y, Akiyama Y, Miyazato Y, Nomoto H, Nakamoto T, Ota M, Sakamoto K, Katsuno T, Kusaba Y, Ishikane M, Kinoshita N, Yamamoto K, Ujiie M, Kutsuna S, Hashimoto M, Suzuki M, Izumi S, Katagiri D, Hojo M, Ohmagari N. Psychiatric burdens or stress during hospitalization and concerns after discharge in patients with severe acute respiratory syndrome coronavirus-2 isolated in a tertiary care hospital. Psychiatry Res 2020; 289:113040. [PMID: 32387791 PMCID: PMC7194882 DOI: 10.1016/j.psychres.2020.113040] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 04/25/2020] [Accepted: 04/25/2020] [Indexed: 11/19/2022]
Abstract
•Quarantined inpatients with SARS-CoV-2 have psychiatric burdens.•Some inpatients had discrimination, prejudice, and suspension and dismissal from work.•Implementation of necessary measures is needed to minimize the risk of long-term social isolation and potential risk of suicide.
Collapse
Affiliation(s)
- Shinichiro Morioka
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Sho Saito
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Kayoko Hayakawa
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Jin Takasaki
- Division of Respiratory Medicine, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Tetsuya Suzuki
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Satoshi Ide
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Keiji Nakamura
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Yuki Moriyama
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Yutaro Akiyama
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Yusuke Miyazato
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Hidetoshi Nomoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Takato Nakamoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Masayuki Ota
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Keita Sakamoto
- Division of Respiratory Medicine, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Takashi Katsuno
- Division of Respiratory Medicine, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Yusaku Kusaba
- Division of Respiratory Medicine, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Masahiro Ishikane
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Noriko Kinoshita
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Kei Yamamoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Mugen Ujiie
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Satoshi Kutsuna
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Masao Hashimoto
- Division of Respiratory Medicine, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Manabu Suzuki
- Division of Respiratory Medicine, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Shinyu Izumi
- Division of Respiratory Medicine, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Daisuke Katagiri
- Division of Nephrology, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Masayuki Hojo
- Division of Respiratory Medicine, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| |
Collapse
|
37
|
Nakamura K, Ide S, Saito S, Kinoshita N, Kutsuna S, Moriyama Y, Suzuki T, Ota M, Nomoto H, Mizoue T, Hojo M, Takasaki J, Asai Y, Terada M, Akiyama Y, Miyazato Y, Nakamoto T, Wakimoto Y, Ujiie M, Yamamoto K, Ishikane M, Morioka S, Hayakawa K, Sugiyama H, Ohmagari N. COVID-19 can suddenly become severe: a case series from Tokyo, Japan. Glob Health Med 2020; 2:174-177. [PMID: 33330803 DOI: 10.35772/ghm.2020.01054] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 06/22/2020] [Accepted: 06/24/2020] [Indexed: 01/08/2023]
Abstract
Since the initial report of coronavirus disease (COVID-19) from the City of Wuhan, China in December 2019, there have been multiple cases globally. Reported here are 11 cases of COVID-19 at this hospital; all of the patients in question presented with relative bradycardia. The severity of the disease was classified into four grades. Of the patients studied, 3 with mild COVID-19 and 3 with moderate COVID-19 improved spontaneously. Lopinavir/ ritonavir was administered to 3 patients with severe COVID-19 and 2 with critical COVID-19. Both patients with critical COVID-19 required mechanical ventilation and extracorporeal membrane oxygenation. Both patients with critical COVID-19 had a higher fever that persisted for longer than patients with milder COVID-19. The respiratory status of patients with critical COVID-19 worsened rapidly 7 days after the onset of symptoms. Relative bradycardia may be useful in distinguishing between COVID-19 and bacterial community-acquired pneumonia. In patients who have had a fever for > 7 days, the condition might worsen suddenly.
Collapse
Affiliation(s)
- Keiji Nakamura
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Satoshi Ide
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Sho Saito
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Noriko Kinoshita
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Satoshi Kutsuna
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yuki Moriyama
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tetsuya Suzuki
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masayuki Ota
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hidetoshi Nomoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masayuki Hojo
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Jin Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yusuke Asai
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Mari Terada
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yutaro Akiyama
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yusuke Miyazato
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takato Nakamoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yuji Wakimoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Mugen Ujiie
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kei Yamamoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masahiro Ishikane
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinichiro Morioka
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kayoko Hayakawa
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | | | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| |
Collapse
|
38
|
Hayakawa K, Kutsuna S, Kawamata T, Sugiki Y, Nonaka C, Tanaka K, Shoji M, Nagai M, Tezuka S, Shinya K, Saito H, Harada T, Moriya N, Tsuboi M, Norizuki M, Sugiura Y, Osanai Y, Sugiyama M, Okuhama A, Kanda K, Wakimoto Y, Ujiie M, Morioka S, Yamamoto K, Kinoshita N, Ishikane M, Saito S, Moriyama Y, Ota M, Nakamura K, Nakamoto T, Ide S, Nomoto H, Akiyama Y, Suzuki T, Miyazato Y, Gu Y, Matsunaga N, Tsuzuki S, Fujitomo Y, Kusama Y, Shichino H, Kaneshige M, Yamanaka J, Saito M, Hojo M, Hashimoto M, Izumi S, Takasaki J, Suzuki M, Sakamoto K, Hiroi Y, Emoto S, Tokuhara M, Kobayashi T, Tomiyama K, Nakamura F, Ohmagari N, Sugiyama H. SARS-CoV-2 infection among returnees on charter flights to Japan from Hubei, China: a report from National Center for Global Health and Medicine. Glob Health Med 2020; 2:107-111. [PMID: 33330786 DOI: 10.35772/ghm.2020.01036] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 04/22/2020] [Accepted: 04/25/2020] [Indexed: 11/08/2022]
Abstract
Due to the significant spread of a new type of coronavirus (SARS-CoV-2) infection (COVID-19) in China, the Chinese government blockaded several cities in Hubei Province. Japanese citizens lost a means of transportation to return back to Japan. The National Center for Global Health and Medicine (NCGM) helped the operation of charter flights for evacuation of Japanese residents from Hubei Province, and this article outlines our experiences. A total of five charter flights were dispatched, and the majority of returnees (793/829 [95.7%]) were handled at NCGM. A large number of personnel from various departments participated in this operation; 107 physicians, 115 nurses, 110 clerical staff, and 45 laboratory technicians in total. Several medical translators were also involved. In this operation, we conducted airborne precautions in addition to contact precautions. Eye shields were also used. The doctors collecting the pharyngeal swab used a coverall to minimize the risk of body surface contamination from secretions and droplets. Enhanced hand hygiene using alcohol hand sanitizer was performed. Forty-eight persons were ultimately hospitalized after the triage at NCGM operation, which was more than the number of persons triaged at the airport (n = 34). Of those hospitalized after NCGM triage, 8.3% (4/48 patients) ultimately tested positive for SARS-CoV-2, significantly higher than the positive rate among subjects not triaged (4/48 [8.3%] vs. 9/745 [1.2%]: p = 0.0057). NCGM participated in a large-scale operation to evacuate Japanese nationals from the COVID-19 epidemic area. We were able to establish a scheme through this experience that can be used in the future.
Collapse
Affiliation(s)
- Kayoko Hayakawa
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Satoshi Kutsuna
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takeo Kawamata
- National Center for Global Health and Medicine, Tokyo, Japan
| | - Yuko Sugiki
- Infection Control Team, National Center for Global Health and Medicine, Tokyo, Japan.,Department of Nursing, National Center for Global Health and Medicine, Tokyo, Japan
| | - Chiharu Nonaka
- Department of Nursing, National Center for Global Health and Medicine, Tokyo, Japan
| | - Keiko Tanaka
- Department of Nursing, National Center for Global Health and Medicine, Tokyo, Japan
| | - Michi Shoji
- Department of Clinical Laboratory, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masaki Nagai
- Department of Clinical Laboratory, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shunsuke Tezuka
- Department of Clinical Laboratory, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kazuyuki Shinya
- Department of Clinical Laboratory, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiroki Saito
- Department of Clinical Laboratory, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takahiro Harada
- Department of Clinical Laboratory, National Center for Global Health and Medicine, Tokyo, Japan
| | - Nin Moriya
- Department of Clinical Laboratory, National Center for Global Health and Medicine, Tokyo, Japan
| | - Motoyuki Tsuboi
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masataro Norizuki
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yasuo Sugiura
- International Health Care Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yasuyo Osanai
- Department of Nursing, National Center for Global Health and Medicine, Tokyo, Japan.,International Health Care Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masaya Sugiyama
- Genome Medical Sciences Project, National Center for Global Health and Medicine, Tokyo, Japan
| | - Ayako Okuhama
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kohei Kanda
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yuji Wakimoto
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Mugen Ujiie
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinichiro Morioka
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kei Yamamoto
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Noriko Kinoshita
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masahiro Ishikane
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Sho Saito
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yuki Moriyama
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masayuki Ota
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Keiji Nakamura
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takato Nakamoto
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Satoshi Ide
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hidetoshi Nomoto
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yutaro Akiyama
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tetsuya Suzuki
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yusuke Miyazato
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yoshiaki Gu
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Nobuaki Matsunaga
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinya Tsuzuki
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yumiko Fujitomo
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yoshiki Kusama
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiroyuki Shichino
- Department of Pediatrics, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masao Kaneshige
- Department of Pediatrics, National Center for Global Health and Medicine, Tokyo, Japan
| | - Junko Yamanaka
- Department of Pediatrics, National Center for Global Health and Medicine, Tokyo, Japan
| | - Miki Saito
- Department of Pediatrics, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masayuki Hojo
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masao Hashimoto
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinyu Izumi
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Jin Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Manabu Suzuki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Keita Sakamoto
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yukio Hiroi
- Department of Cardiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Sakurako Emoto
- Department of Cardiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Makoto Tokuhara
- Department of Palliative care, National Center for Global Health and Medicine, Tokyo, Japan
| | - Toshiaki Kobayashi
- Department of Rheumatology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Koichiro Tomiyama
- Department of Emergency Medicine & Critical Care, National Center for Global Health and Medicine, Tokyo, Japan
| | - Fumihiko Nakamura
- Department of Hematology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norio Ohmagari
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Haruhito Sugiyama
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan.,Center Hospital, National Center for Global Health and Medicine, Tokyo, Japan
| |
Collapse
|
39
|
Kakuwa T, Ariga A, Takasaki J, Kato M, Igari T, Shida Y, Okafuji T, Nakamura S, Miyazaki Y, Katano H, Iikura M, Izumi S, Sugiyama H. Mucor pulmonary embolism in a patient with myelodysplastic syndrome. Respir Med Case Rep 2020; 30:101035. [PMID: 32190545 PMCID: PMC7068122 DOI: 10.1016/j.rmcr.2020.101035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 03/02/2020] [Accepted: 03/02/2020] [Indexed: 11/28/2022] Open
Abstract
Mucormycosis is a life-threatening infectious disease that occurs most commonly in immunocompromised patients such as those with hematological malignancies. Its clinical symptoms and associated radiological findings vary and specific biomarkers and culture characteristics have not been defined. An 85-year-old man who had been treated for myelodysplastic syndrome and tuberculosis for several months presented with subacute fever and worsening left-side chest pain. Contrast-enhanced computed tomography images depicted massive tumor-like consolidation without enhancement, expanding from the left lower lobe. Emboli that did not respond to anticoagulants were detected in the left descending pulmonary artery. Despite intensive treatment he developed multiple organ failure and died 47 days after hospitalization. Gross pathology of a lung autopsy specimen revealed left lower pulmonary arterial emboli and pulmonary infarction, which was concluded to be the direct cause of death. The emboli were histopathologically identified as invasive mycelia in vessels. Mucor sp. was detected via real-time polymerase chain reaction and immunohistopathological analyses revealed that the mold in the blood vessels of lung tissue was partially positive for the mucor antigen. In the present case of Mucor sp. pulmonary emboli in a patient with myelodysplastic syndrome, radiographic findings were hard to distinguish from those typical of a lung abscess.
Collapse
Affiliation(s)
- T Kakuwa
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - A Ariga
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan.,Department of Orthopedics, Tokyo Medical and Dental University, Tokyo, Japan
| | - J Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - M Kato
- Department of Pathology, National Center for Global Health and Medicine, Tokyo, Japan
| | - T Igari
- Department of Pathology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Y Shida
- Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - T Okafuji
- Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - S Nakamura
- Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, Tokyo, Japan.,Department of Microbiology, Tokyo Medical University, Tokyo, Japan
| | - Y Miyazaki
- Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, Tokyo, Japan
| | - H Katano
- Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan
| | - M Iikura
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - S Izumi
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - H Sugiyama
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| |
Collapse
|
40
|
Ngo CQ, Manabe T, Vu GV, Chu HT, Vu TTT, Tran TT, Doan LTP, Takasaki J, Kudo K. Difficulties in tuberculosis infection control in a general hospital of Vietnam: a knowledge, attitude, and practice survey and screening for latent tuberculosis infection among health professionals. BMC Infect Dis 2019; 19:951. [PMID: 31703561 PMCID: PMC6842132 DOI: 10.1186/s12879-019-4593-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 10/24/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In Vietnam, a country with a high tuberculosis (TB) burden, health professionals in both TB-specialized and non-TB-specialized general hospitals have a high risk of acquiring TB. The aims of the present study were to clarify the difficulties in TB infection control at non-TB specialized hospitals and whether any associated risks of latent TB infection exist among health professionals in Vietnam. METHODS We conducted a cross-sectional study in a national tertiary and general hospital of Hanoi, Vietnam. Participants were health professionals, including physicians, nurses, and other health professionals. We assessed difficulties in TB infection control by conducting a knowledge, attitude, and practice (KAP) survey. We also collected data on the results of tuberculin skin tests (TSTs) conducted during health check-ups for hospital staff to determine whether health professionals had latent TB infection or TB disease. KAP scores were compared among health professional groups (physicians vs. nurses vs. other health professionals). Factors influencing knowledge scores were evaluated using multiple regression analysis. RESULTS A total 440 health professionals at the study site participated in the KAP survey, and we collected the results of TSTs from a total of 299 health professionals. We observed a high prevalence of latent TB infection (74.2%), especially among participants in the emergency department. Although participants had high KAP scores, some topics were less understood, such as symptoms and risks of TB, proper use of protective equipment such as N95 respirators, and preventing transmission by patients with confirmed or suspected TB. Factors influencing knowledge scores associated with TB were age, a belief that TB is the most important infectious disease, being a medical professional, having previously attended workshops or seminars, and knowing that Vietnam has a high burden of TB. CONCLUSION In a non-TB specialized hospital of Vietnam, we observed a risk of TB infection among health professionals and difficulties in properly controlling TB infection. Early awareness regarding patients with suspected TB, to apply proper measures and prevent transmission, and education regarding obtaining updated knowledge through scientific information are crucial to enhancing TB infection control in general hospitals of Vietnam.
Collapse
Affiliation(s)
| | - Toshie Manabe
- Jichi Medical University, Center for Community Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498 Japan
| | | | | | | | | | | | - Jin Takasaki
- National Center for Global Health and Medicine, Division of Pulmonary Medicine, Tokyo, Japan
| | - Koichiro Kudo
- Waseda University Organization for Regional and Inter-Regional Studies, Tokyo, Japan
- Yurin Hospital, Tokyo, Japan
| |
Collapse
|
41
|
Yanagihara K, Matsumoto T, Aoki N, Sato J, Wakamura T, Kiyota H, Tateda K, Hanaki H, Ohsaki Y, Fujiuchi S, Takahashi M, Akiba Y, Masunaga S, Takeuchi K, Takeda H, Miki M, Kumagai T, Takahashi H, Utagawa M, Nishiya H, Kawakami S, Ishigaki S, Kobayasi N, Takasaki J, Mezaki K, Iwata S, Katouno Y, Inose R, Niki Y, Kawana A, Fujikura Y, Kudo M, Hirano T, Yamamoto M, Miyazawa N, Tsukada H, Aso S, Yamamoto Y, Iinuma Y, Mikamo H, Yamagishi Y, Nakamura A, Ohashi M, Kawabata A, Sugaki Y, Seki M, Hamaguchi S, Toyokawa M, Kakeya H, Fujikawa Y, Mitsuno N, Ukimura A, Miyara T, Hayasi M, Mikasa K, Kasahara K, Koizumi A, Korohasi N, Matumoto T, Yosimura Y, Katanami Y, Takesue Y, Wada Y, Sugimoto K, Yamamoto T, Kuwabara M, Doi M, Simizu S, Tokuyasu H, Hino S, Negayama K, Mukae H, Kawanami T, Yatera K, Fujita M, Kadota J, Hiramatsu K, Aoki Y, Magarifuchi H, Oho M, Morinaga Y, Suga M, Muranaka H, Fujita J, Higa F, Tateyama M. Nationwide surveillance of bacterial respiratory pathogens conducted by the surveillance committee of Japanese Society of Chemotherapy, the Japanese Association for Infectious Diseases, and the Japanese Society for clinical microbiology in 2014: General view of the pathogens' antibacterial susceptibility. J Infect Chemother 2019; 25:657-668. [PMID: 31196772 DOI: 10.1016/j.jiac.2019.05.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 03/18/2019] [Accepted: 05/15/2019] [Indexed: 11/28/2022]
Abstract
The nationwide surveillance on antimicrobial susceptibility of bacterial respiratory pathogens from the patients in Japan was conducted by Japanese Society of Chemotherapy, the Japanese Association for Infectious Diseases, and the Japanese Society for Clinical Microbiology in 2014. The isolates were collected from clinical specimens obtained from well-diagnosed adult patients with respiratory tract infections during the period between January 2014 and April 2015 by three societies. Antimicrobial susceptibility testing was conducted at the central reference laboratory according to the method recommended by Clinical Laboratory Standards Institute. Susceptibility testing was evaluated in 1534 strains (335 Staphylococcus aureus, 264 Streptococcus pneumoniae, 29 Streptococcus pyogenes, 281 Haemophilus influenzae, 164 Moraxella catarrhalis, 207 Klebsiella pneumoniae, and 254 Pseudomonas aeruginosa). Ratio of methicillin-resistant S. aureus was 43.6%, and those of penicillin-susceptible S. pneumoniae was 100%. Among H. influenzae, 8.2% of them were found to be β-lactamase-producing ampicillin-resistant strains, and 49.1% to be β-lactamase-non-producing ampicillin-resistant strains. Extended spectrum β-lactamase-producing K. pneumoniae and multi-drug resistant P. aeruginosa with metallo β-lactamase were 9.2% and 0.4%, respectively.
Collapse
Affiliation(s)
- Katsunori Yanagihara
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Nagasaki University School of Medicine, Nagasaki, Japan.
| | - Tetsuya Matsumoto
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan
| | - Nobuki Aoki
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan
| | - Junko Sato
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan
| | - Tomotaro Wakamura
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan
| | - Hiroshi Kiyota
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan
| | - Kazuhiro Tateda
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan
| | | | | | - Satoru Fujiuchi
- National Hospital Organization Asahikawa Medical Center, Hokkaido, Japan
| | - Manabu Takahashi
- National Hospital Organization Asahikawa Medical Center, Hokkaido, Japan
| | - Yuji Akiba
- Asahikawa Kosei Hospital, Hokkaido, Japan
| | | | | | | | - Makoto Miki
- Japanese Red Cross Sendai Hospital, Miyagi, Japan
| | | | | | | | | | | | | | | | - Jin Takasaki
- National Center for Global Health and Medicine, Tokyo, Japan
| | - Kazuhisa Mezaki
- National Center for Global Health and Medicine, Tokyo, Japan
| | | | | | | | | | - Akihiko Kawana
- National Defense Medical College Hospital, Saitama, Japan
| | - Yuji Fujikura
- National Defense Medical College Hospital, Saitama, Japan
| | - Makoto Kudo
- Yokohama City University Hospital, Kanagawa, Japan
| | - Tomo Hirano
- Yokohama City University Hospital, Kanagawa, Japan
| | | | | | | | - Sakura Aso
- Niigata City General Hospital, Niigata, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Keiichi Mikasa
- Center for Infectious Diseases, Nara Medical University, Nara, Japan
| | - Kei Kasahara
- Center for Infectious Diseases, Nara Medical University, Nara, Japan
| | - Akira Koizumi
- Center for Infectious Diseases, Nara Medical University, Nara, Japan
| | | | | | | | | | | | - Yasunao Wada
- Hyogo College of Medicine Hospital, Hyogo, Japan
| | | | | | | | - Masao Doi
- Hiroshima Prefectural Hospital, Hiroshima, Japan
| | | | | | | | | | - Hiroshi Mukae
- University of Occupational and Environmental Health Hospital, Fukuoka, Japan; Nagasaki University School of Medicine, Nagasaki, Japan
| | - Toshinori Kawanami
- University of Occupational and Environmental Health Hospital, Fukuoka, Japan
| | - Kazuhiro Yatera
- University of Occupational and Environmental Health Hospital, Fukuoka, Japan
| | - Masaki Fujita
- Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | | | | | | | | | | | | | | | | | - Jiro Fujita
- Department of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus, Okinawa, Japan
| | - Futoshi Higa
- Department of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus, Okinawa, Japan
| | - Masao Tateyama
- Department of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus, Okinawa, Japan
| |
Collapse
|
42
|
Abstract
BACKGROUND The seasonality of pulmonary tuberculosis (TB) incidence may indicate season-specific risk factors that could be controlled if they were better understood. The aims of this study were to elucidate how the incidence of TB changes seasonally and to determine the factors influencing TB incidence, to reduce the TB burden in Japan. METHODS We assessed the seasonality of newly notified TB cases in Japan using national surveillance data collected between 2007 and 2015. To investigate age and sex differences, seasonal variation was analyzed according to sex for all cases and then by stratified age groups (0-4, 5-14, 15-24, 25-44, 45-64, 65-74, and ≥ 75 years). We used Roger's test to analyze the cyclic monthly trends in seasonal variation of TB incidence. RESULTS A total of 199,856 newly notified TB cases (male, 62.2%) were reported over the past 9-year period. Among them, 60.6% involved patients aged ≥65 years. Overall, the peak months of TB incidence occurred from April to October, excluding September. In the analysis stratified by age group, a significant seasonal variation in TB cases was observed for age groups ≥15 years, whereas no seasonal variation was observed for age groups ≤14 years. For female patients aged ≥25 years, the peak TB epidemic period was seen from June to December, excluding November. Male patients in the same age groups exhibited declining TB incidence from September to March. CONCLUSIONS TB incidence exhibits seasonality in Japan for people aged > 15 years and peaks in summer to fall. Monthly trends differ according to age and sex. For age groups ≥25 years, cases in women showed longer peaks from June to December whereas cases in men declined from September to December. These results suggest that the seasonality of TB incidence in Japan might be influenced by health checkups in young adults, reactivation of latent TB infection with aging, and lifestyle habits in older adults. These findings can contribute to establishing the potential determinants of TB seasonality in Japan.
Collapse
Affiliation(s)
- Toshie Manabe
- Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, 333-1 Yakushiji, Shimotsuke, Tochigi, Japan. .,Waseda University Organization of Regional and Inter-Regional Studies, Tokyo, Japan. .,Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.
| | - Jin Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Koichiro Kudo
- Waseda University Organization of Regional and Inter-Regional Studies, Tokyo, Japan
| |
Collapse
|
43
|
Suzuki M, Araki K, Matsubayashi S, Kobayashi K, Morino E, Takasaki J, Iikura M, Izumi S, Takeda Y, Sugiyama H. A case of recurrent hemoptysis caused by pulmonary actinomycosis diagnosed using transbronchial lung biopsy after bronchial artery embolism and a brief review of the literature. Ann Transl Med 2019; 7:108. [PMID: 31019958 DOI: 10.21037/atm.2019.02.11] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A 60-year-old man was admitted to our hospital because of massive hemoptysis with acute respiratory failure. Since six months ago, he noticed gradual worsening of hemoptysis and was transferred to our hospital. Chest computed tomography showed a nodular lesion with cavitation in the left upper lobe and surrounding ground-glass opacification. Initially, a hemostatic agent was administered, but we eventually performed bronchial artery embolization (BAE) by ourselves due to persistent hemoptysis. After achieving good hemostasis with BAE bronchoscopy was performed, which gave a diagnosis of pulmonary actinomycosis on histopathologic examination of the transbronchial biopsy specimen without the need for lung resection.
Collapse
Affiliation(s)
- Manabu Suzuki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kyoko Araki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Sachi Matsubayashi
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Konomi Kobayashi
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Eriko Morino
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Jin Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Motoyasu Iikura
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinyu Izumi
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yuichiro Takeda
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Haruhito Sugiyama
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| |
Collapse
|
44
|
Morimoto K, Nakagawa T, Asami T, Morino E, Fujiwara H, Hase I, Tsujimoto Y, Izumi K, Hayashi Y, Matsuda S, Murase Y, Yano R, Takasaki J, Betsuyaku T, Aono A, Goto H, Nishimura T, Sasaki Y, Hoshino Y, Kurashima A, Ato M, Ogawa K, Hasegawa N, Mitarai S. Clinico-microbiological analysis of 121 patients with pulmonary Mycobacteroides abscessus complex disease in Japan - An NTM-JRC study with RIT. Respir Med 2018; 145:14-20. [PMID: 30509703 DOI: 10.1016/j.rmed.2018.10.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 09/10/2018] [Accepted: 10/15/2018] [Indexed: 11/18/2022]
Abstract
RATIONALE No comprehensive analysis has previously been performed to evaluate the clinical aspects of and microbiological evidence associated with Mycobacteroides abscessus complex (MABC) infection in a region, such as Japan, with a low MABC incidence. OBJECTIVES This study aimed to clarify the clinicopathological characteristics of MABC, which included clinical relatedness to erm(41) sequevar, phenotype (as colony morphology and minimum inhibitory concentration), and genotype. METHODS A total of 121 MABC patients (68 with M. abscessus subsp. abscessus and 53 with M. abscessus subsp. massiliense) were recruited into this retrospective clinical-biological study from tertiary hospitals in Japan between 2004 and 2014. RESULTS Approximately 30% of MABC patients had a history of previous nontuberculous mycobacterium (NTM) disease. Furthermore, 24.8% of the patients had another concomitant NTM infection after they were diagnosed with MABC. Fewer than 10% of the patients in the M. abscessus group had T28C in erm(41). While we observed a higher conversion rate for M. massiliense than for M. abscessus (72.4% and 34.8%, respectively, p = 0.002), recurrence remained relatively common for M. massiliense (31.0%). In the M. abscessus patients, the MIC of clarithromycin (CLR) was significantly lower on day 3 in patients with a better treatment response than in refractory patients (The median MIC; 0.75 μg/ml v.s 2.0 μg/ml, p = 0.03). There was no significant relation between clinical manifestations and variable number of tandem repeat genotypes. CONCLUSIONS Because the history and simultaneous isolation of other NTM in MABC infection are relatively common, these information should be carefully translated into clinical actions. The evaluation of early CLR resistance in M. abscessus and the erm(41) functions should be important to improve the treatment strategy.
Collapse
Affiliation(s)
- Kozo Morimoto
- Division of Clinical Research, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan; Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan; Department of Mycobacterium Reference and Research, The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan.
| | - Taku Nakagawa
- Department of Respiratory medicine, National Hospital Organization, Higashinagoya National Hospital, Nagoya, Japan
| | - Takahiro Asami
- Division of Pulmonary Medicine, School of Medicine, Keio University, Tokyo, Japan
| | - Eriko Morino
- Department of Respiratory Medicine, Division of Infectious Diseases, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiroshi Fujiwara
- Division of Pulmonary Medicine, School of Medicine, Keio University, Tokyo, Japan
| | - Isano Hase
- Department of Respiratory Medicine, National Hospital Organization, Utsunomiya Hospital, Utsunomiya, Japan
| | - Yoshie Tsujimoto
- Department of Respiratory Medicine, Division of Infectious Diseases, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kiyohiko Izumi
- Department of Epidemiology and Clinical Research, The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan; Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Yuta Hayashi
- Department of Respiratory medicine, National Hospital Organization, Higashinagoya National Hospital, Nagoya, Japan
| | - Shuichi Matsuda
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Yoshiro Murase
- Department of Mycobacterium Reference and Research, The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Ryozo Yano
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Jin Takasaki
- Department of Respiratory Medicine, Division of Infectious Diseases, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tomoko Betsuyaku
- Division of Pulmonary Medicine, School of Medicine, Keio University, Tokyo, Japan
| | - Akio Aono
- Department of Mycobacterium Reference and Research, The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Hajime Goto
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | | | - Yuka Sasaki
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Yoshihiko Hoshino
- Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Atsuyuki Kurashima
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Manabu Ato
- Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kenji Ogawa
- Department of Respiratory medicine, National Hospital Organization, Higashinagoya National Hospital, Nagoya, Japan
| | - Naoki Hasegawa
- Center for Infectious Diseases and Infection Control, Keio University School of Medicine, Tokyo, Japan
| | - Satoshi Mitarai
- Department of Mycobacterium Reference and Research, The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan; Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| |
Collapse
|
45
|
Futami A, Morino E, Shiraishi S, Hori N, Takasaki J. 4.10-P19Trend analysis of migrants and asylum seeker Tuberculosis patients in a Japanese hospital. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky048.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Futami
- National Centre for Global Health and Medicine, Japan
| | - E Morino
- National Centre for Global Health and Medicine, Japan
| | - S Shiraishi
- National Centre for Global Health and Medicine, Japan
| | - N Hori
- National Centre for Global Health and Medicine, Japan
| | - J Takasaki
- National Centre for Global Health and Medicine, Japan
| |
Collapse
|
46
|
Kawamoto H, Suzuki M, Shiozawa A, Miyawaki E, Yamamoto S, Kobayashi K, Takasaki J, Takeda Y, Hojo M, Sugiyama H. Massive Hemoptysis with a Fungus Ball-like Shadow in an Old Tuberculosis Cavity That Was Shown to Be a Clot by Bronchoscopy. Intern Med 2018; 57:377-381. [PMID: 29093390 PMCID: PMC5827319 DOI: 10.2169/internalmedicine.8967-17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Development of aspergilloma is common in cases with a fungus ball-like shadow in cavities due to old tuberculosis. Some reports have shown that blood clots tend to appear as a fungus ball-like shadow. A 71-year-old man with a history of pulmonary tuberculosis presented with a fungus ball-like shadow in an old cavity and hemoptysis. There was no evidence of aspergillus infection on various examinations. We confirmed a blood clot and aneurysm of an artery under direct vision by bronchoscopy. A lateral thoracic artery aneurysm was detected by angiography. Transcatheter arterial embolization was performed. After treatment, the artery aneurysm disappeared.
Collapse
Affiliation(s)
- Hironori Kawamoto
- Division of Respiratory Medicine, National Center for Global Health and Medicine, Japan
- Department of Respiratory Medicine, Jikei University Hospital, Japan
| | - Manabu Suzuki
- Division of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Ayako Shiozawa
- Division of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Eriko Miyawaki
- Division of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Shota Yamamoto
- Division of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Konomi Kobayashi
- Division of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Jin Takasaki
- Division of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Yuichiro Takeda
- Division of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Masayuki Hojo
- Division of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Haruhito Sugiyama
- Division of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| |
Collapse
|
47
|
Matono T, Nishijima T, Teruya K, Morino E, Takasaki J, Gatanaga H, Kikuchi Y, Kaku M, Oka S. Substantially Higher and Earlier Occurrence of Anti-Tuberculosis Drug-Related Adverse Reactions in HIV Coinfected Tuberculosis Patients: A Matched-Cohort Study. AIDS Patient Care STDS 2017; 31:455-462. [PMID: 29087745 DOI: 10.1089/apc.2017.0116] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Little information exists on the frequency, severity, and timing of first-line anti-tuberculosis drug-related adverse events (TB-AEs) in HIV-tuberculosis coinfected (HIV-TB) patients in the antiretroviral therapy (ART) era. This matched-cohort study included HIV-TB patients as cases and HIV-uninfected tuberculosis (non-HIV-TB) patients as controls. Tuberculosis was culture-confirmed in both groups. Cases were matched to controls in a 1:4 ratio on age, sex, and year of diagnosis. TB-AEs were defined as Grade 2 or higher requiring drug discontinuation/regimen change. From 2003 to 2015, 94 cases and 376 controls were analyzed (95% men, 98% Asians). Standard four-drug combination therapy was initiated in 91% of cases and 89% of controls (p = 0.45). Cases had a higher frequency of TB-AE [51% (48/94) vs. 10% (39/376), p < 0.001]. Their major TB-AEs were fever (19%), rash (11%), and neutropenia (11%). TB-AEs were more severe in cases [Grade 3 or higher: cases (71%, 34/48) vs. controls (49%, 19/39), p < 0.001]. The time from treatment initiation to TB-AE was shorter in cases [median 18 (interquartile range 12-28) vs. 27 (15-57) days, p = 0.027], and 73% of TB-AEs in cases occurred within 4 weeks of starting anti-tuberculosis treatment. HIV infection was an independent risk factor for TB-AEs in the multivariate Cox analysis [adjusted HR (aHR): 6.96; 95% confidence interval: 3.93-12.3]. TB-AEs occurred more frequently in HIV-TB than in non-HIV-TB patients, and were more severe. The majority of TB-AEs occurred within 4 weeks of initiating anti-tuberculosis treatment. Because TB-AEs may delay ART initiation, careful monitoring during this period is warranted in coinfected patients.
Collapse
Affiliation(s)
- Takashi Matono
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
- Department of Infection Control and Laboratory Diagnostics, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takeshi Nishijima
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Katsuji Teruya
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Eriko Morino
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Jin Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiroyuki Gatanaga
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yoshimi Kikuchi
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Mitsuo Kaku
- Department of Infection Control and Laboratory Diagnostics, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shinichi Oka
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| |
Collapse
|
48
|
Yanagihara K, Watanabe A, Aoki N, Matsumoto T, Yoshida M, Sato J, Wakamura T, Sunakawa K, Kadota J, Kiyota H, Iwata S, Kaku M, Hanaki H, Ohsaki Y, Fujiuchi S, Takahashi M, Takeuchi K, Takeda H, Ikeda H, Miki M, Nakanowatari S, Takahashi H, Utagawa M, Nishiya H, Kawakami S, Morino E, Takasaki J, Mezaki K, Chonabayashi N, Tanaka C, Sugiura H, Goto H, Saraya T, Kurai D, Katono Y, Inose R, Niki Y, Takuma T, Kudo M, Ehara S, Sato Y, Tsukada H, Watabe N, Honma Y, Mikamo H, Yamagishi Y, Nakamura A, Ohashi M, Seki M, Hamaguchi S, Toyokawa M, Fujikawa Y, Mitsuno N, Ukimura A, Miyara T, Nakamura T, Mikasa K, Kasahara K, Ui K, Fukuda S, Nakamura A, Morimura M, Yamashita M, Takesue Y, Wada Y, Sugimoto K, Kusano N, Nose M, Mihara E, Kuwabara M, Doi M, Watanabe Y, Tokuyasu H, Hino S, Negayama K, Mukae H, Kawanami T, Ota T, Fujita M, Honda J, Hiramatsu K, Aoki Y, Fukuoka M, Magarifuchi H, Nagasawa Z, Kaku N, Fujita J, Higa F, Tateyama M. Nationwide surveillance of bacterial respiratory pathogens conducted by the surveillance committee of Japanese Society of Chemotherapy, the Japanese Association for Infectious Diseases, and the Japanese Society for Clinical Microbiology in 2012: General view of the pathogens' antibacterial susceptibility. J Infect Chemother 2017; 23:587-597. [PMID: 28669567 DOI: 10.1016/j.jiac.2017.05.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 05/16/2017] [Accepted: 05/31/2017] [Indexed: 10/19/2022]
Abstract
The nationwide surveillance on antimicrobial susceptibility of bacterial respiratory pathogens from the patients in Japan was conducted by Japanese Society of Chemotherapy, Japanese association for infectious diseases and Japanese society for Clinical Microbiology in 2012. The isolates were collected from clinical specimens obtained from well-diagnosed adult patients with respiratory tract infections during the period between January and December in 2012 by three societies. Antimicrobial susceptibility testing was conducted at the central reference laboratory according to the method recommended by Clinical Laboratory Standard Institutes. Susceptibility testing was evaluated in 1236 strains (232 Staphylococcus aureus, 225 Streptococcus pneumoniae, 16 Streptococcus pyogenes, 231 Haemophilus influenzae, 147 Moraxella catarrhalis, 167 Klebsiella pneumoniae and 218 Pseudomonas aeruginosa). Ratio of methicillin-resistant S. aureus was 51.3%, and those of penicillin-intermediate S. pneumoniae was 0.4%. Among H. influenzae, 5.6% of them were found to be β-lactamase-producing ampicillin-resistant strains, and 37.2% to be β-lactamase-non-producing ampicillin-resistant strains. Extended spectrum β-lactamase-producing K. pneumoniae and multi-drug resistant P. aeruginosa with metallo β-lactamase were 4.2% and 3.2%, respectively. Continuous national surveillance is important to determine the actual situation of the resistance shown by bacterial respiratory pathogens to antimicrobial agents.
Collapse
Affiliation(s)
- Katsunori Yanagihara
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), and The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Nagasaki University School of Medicine, Nagasaki, Japan.
| | - Akira Watanabe
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), and The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan
| | - Nobuki Aoki
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), and The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Shinrakuen Hospital, Niigata, Japan
| | - Tetsuya Matsumoto
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), and The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan
| | - Masaki Yoshida
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), and The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan
| | - Junko Sato
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), and The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan
| | - Tomotaro Wakamura
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), and The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan
| | - Keisuke Sunakawa
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), and The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan
| | - Junichi Kadota
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), and The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Oita University Faculty of Medicine, Oita, Japan
| | - Hiroshi Kiyota
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), and The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan
| | - Satoshi Iwata
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), and The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Keio University Hospital, Tokyo, Japan
| | - Mitsuo Kaku
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), and The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan
| | | | | | - Satoru Fujiuchi
- National Hospital Organization Asahikawa Medical Center, Hokkaido, Japan
| | - Manabu Takahashi
- National Hospital Organization Asahikawa Medical Center, Hokkaido, Japan
| | | | | | | | - Makoto Miki
- Japanese Red Cross Sendai Hospital, Miyagi, Japan
| | | | | | | | | | | | - Eriko Morino
- National Center for Global Health and Medicine, Tokyo, Japan
| | - Jin Takasaki
- National Center for Global Health and Medicine, Tokyo, Japan
| | - Kazuhisa Mezaki
- National Center for Global Health and Medicine, Tokyo, Japan
| | | | - Chie Tanaka
- St. Luke's International Hospital, Tokyo, Japan
| | | | | | | | | | | | | | | | | | - Makoto Kudo
- Yokohama City University Hospital, Kanagawa, Japan
| | | | - Yoshimi Sato
- Yokohama City University Hospital, Kanagawa, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Takahito Nakamura
- Japan Community Health Care Organization Hoshigaoka Medical Center, Osaka, Japan
| | - Keiichi Mikasa
- Center for Infectious Diseases, Nara Medical University, Nara, Japan
| | - Kei Kasahara
- Center for Infectious Diseases, Nara Medical University, Nara, Japan
| | - Koji Ui
- Center for Infectious Diseases, Nara Medical University, Nara, Japan
| | | | | | | | | | | | - Yasunao Wada
- Hyogo College of Medicine Hospital, Hyogo, Japan
| | | | | | | | | | | | - Masao Doi
- Hiroshima Prefectural Hospital, Hiroshima, Japan
| | | | | | | | | | - Hiroshi Mukae
- Hospital of the University of Occupational and Environmental Health Japan, Fukuoka, Japan; Nagasaki University School of Medicine, Nagasaki, Japan
| | - Toshinori Kawanami
- Hospital of the University of Occupational and Environmental Health Japan, Fukuoka, Japan
| | - Toshiyuki Ota
- Hospital of the University of Occupational and Environmental Health Japan, Fukuoka, Japan
| | - Masaki Fujita
- Faculty of Medicine, Fukuoka University, Fukuoka, Fukuoka, Japan
| | | | | | - Yosuke Aoki
- Saga University, School of Medicine, Saga, Japan
| | - Mami Fukuoka
- Saga University, School of Medicine, Saga, Japan
| | | | | | - Norihito Kaku
- Nagasaki University School of Medicine, Nagasaki, Japan
| | - Jiro Fujita
- Faculty of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Futoshi Higa
- Faculty of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Masao Tateyama
- Faculty of Medicine, University of the Ryukyus, Okinawa, Japan
| |
Collapse
|
49
|
Kudo K, Manabe T, Izumi S, Takasaki J, Fujikura Y, Kawana A, Yamamoto K. Markers of Disease Severity in Patients with Spanish Influenza in the Japanese Armed Forces, 1919-1920. Emerg Infect Dis 2017; 23:662-664. [PMID: 28322699 PMCID: PMC5367422 DOI: 10.3201/eid2304.152097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
We examined preserved medical charts of 470 Spanish influenza patients (8 with fatal cases) hospitalized at former army hospitals in Japan during 1919–1920. The following factors were associated with longer periods of hospitalization: adventitious discontinuous lung sounds, maximum respiration rate, continuation of high fever after hospital admission, and diphasic fever.
Collapse
|
50
|
Matsubayashi S, Morino E, Tsujimoto Y, Nagano N, Kakuwa T, Sakamoto K, Ishii S, Suzuki M, Takasaki J, Naka G, Iikura M, Izumi S, Takeda Y, Sugiyama H. Risk Factors of Ethambutol Optic Neuropathy Among Patients with Tuberculosis and NTM Infection. Open Forum Infect Dis 2017. [DOI: 10.1093/ofid/ofx163.1939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|